摘要
目的 探索急性上消化道出血采用艾普拉唑钠治疗的可能性及安全性.方法 选取闽侯县祥谦中心卫生院2021年7月至2022年7月收治的52例急性上消化道出血患者为研究对象.根据用药不同分为观察组艾普拉唑钠组和对照组奥美拉唑钠组,每组各26例.比较两组患者有效止血率、出血情况、血细胞比容、血红蛋白水平、住院情况以及安全性.结果 艾普拉唑钠组中23例患者能有效止血,奥美拉唑钠组中24例患者能有效止血,两组患者有效止血率(88.26％vs 92.31％,x2=0.221,P=0.638)组间比较无显著差异.艾普拉唑钠组平均止血时间短于奥美拉唑钠组[(6.4±0.8)h vs(10.5±1.3)h,t=13.696,P＜0.001];艾普拉唑钠组平均出血量明显比奥美拉唑钠组少[(198.6±32.1)ml vs(287.7±46.5)ml,t=8.041,P＜0.001];艾普拉唑钠组再出血发生率也远低于奥美拉唑钠组(3.85％vs 23.08％,x2=4.127,P=0.042).治疗前,两组患者血红蛋白和血细胞比容均无显著差异(P＞0.05);治疗后,两组患者血红蛋白(t=5.900,P＜0.001;t=0.313,P=0.001)和血细胞比容(t=7.961,P＜0.001;t=10.369,P=0.001)均显著升高,且艾普拉唑钠组血红蛋白水平(t=2.562,P=0.007)和血细胞比容(t=4.899,P＜0.001)上升程度比奥美拉唑钠组更明显.艾普拉唑钠组平均住院时间短于奥美拉唑钠组[(7.4±0.9)d vs(9.6±1.2)d,t=7.479,P＜0.001],但艾普拉唑钠组患者的平均治疗费用高于奥美拉唑钠组[(3557.3±452.8)vs(2689.7±366.5),t=7.594,P＜0.001].艾普拉唑钠组中有2例出现不良反应,奥美拉唑钠组中有8例出现不良反应,艾普拉唑钠组的安全性高于奥美拉唑钠组(x2=4.457,P=0.035).结论 艾普拉唑钠治疗急性上消化出血的效果与奥美拉唑钠基本一致,但相比于奥美拉唑钠,艾普拉唑钠止血更快、住院时间更短、出血量更少、再出血率更低,同时改善血红蛋白和血细胞比容效果更好,且使用期间不良反应少,但治疗费用较高.
Abstract
Objective To explore the possibility and safety of treating acute gastrointestinal bleeding with ilaprazole sodium.Methods 52 patients with acute upper gastrointestinal bleeding admitted to Xiangqian Central Health Center in Minhou County from July 2021 to July 2022 were selected as the study subjects.They were divided into the ilaprazole sodium group(observation group,n=26)and the omeprazole sodium group(con-trol group,n=26).The effective hemostasis rate,bleeding status,hematocrit,hospitalization,and safety of the two groups were compared.Results There was no significant difference in the effective hemostasis rate between the two groups(88.26％vs 92.31％,x2=0.221,P=0.638)between 23 patients in the observationgroup and 24 pa-tients in the control group.The mean hemostatic time in the ilaprazole sodium group was significantly shorter than that in the omeprazole sodium group[(6.4±0.8)h vs(10.5±1.3)h,t=13.696,P＜0.001],and the mean blood loss in the ilaprazole sodium group was significantly lower than that in the omeprazole sodium group[(198.6±32.1)ml vs(287.7±46.5)ml,t=8.041,P＜0.001],and the incidence of rebleeding in the ilaprazolesodium group was much lower than that in the omeprazole sodium group(3.85％vs23.08％,x2=4.127,P=0.042).There was no significant difference in hemoglobin and hematocrit(P＞0.05)between the two groups before treatment,but after treatment,hemoglobin(t=5.900,P＜0.001;t=0.313,P=0.001)and he-matocrit(t=7.961,P＜0.001;t=10.369,P=0.001)of the two groups were significantly increased,and the hemoglobin level(t=2.562,P=0.007)and hematocrit(t=4.899,P＜0.001)in the ilaprazolesodium group increased more significantlythan that of omeprazole sodium group.The mean length of hospital stay time in the ilaprazole group was shorter than that in the omeprazole group[(7.4士0.9)d vs(9.6±1.2)d,t=7.479,P＜0.001],but the average treatment cost of patients in the ilaprazole sodium group was higher than that in the omeprazole sodium group[(3557.3±452.8)vs(2689.7±366.5),t=7.594,P＜0.001].There were 2 cases of ad-verse reactions in the ilaprazole sodium group and 8 cases in the omeprazole sodium group,and the safety profile of the ilaprazolesodium group was higher than that of the omeprazole sodium group(x2=4.457,P=0.035).Con-clusion The effect of ilaprazole sodium in the treatment of acute upper digestive bleeding is basically the same as that of omeprazole sodium.But compared with omeprazole sodium,ilaprazole sodium has faster hemostasis,shorter hospital stay,less blood loss,lower rebleeding rate,better improvement of hemoglobin and hematocrit,and fewer adverse reactions during use,but the treatment cost is higher.
维普
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