摘要
目的对比观察2种药物治疗方案治疗内镜黏膜下剥离(ESD)术后人造溃疡的临床疗效,为临床提供参考。方法选取2010年3月-2013年1月在江苏省常熟市第五人民医院行ESD术的患者32例,按照药物治疗方案的不同分为对照组和研究组。对照组16例常规治疗基础上使用奥美拉唑治疗,研究组16例在对照组基础上合用铝碳酸镁治疗。对比观察两组术后1、3、7 d的上腹部症状(包括上腹饱胀、上腹疼痛、嗳气和恶心症状),和两组术后1、4周的溃疡直径和溃疡愈合率,以及药物不良反应发生率,采用SPSS 17.0统计学软件包进行统计分析。结果术后1 d,两组上腹饱胀、上腹疼痛、嗳气和恶心症状评分均差异无统计学意义(P>0.05);术后3 d,研究组和对照组的上腹饱胀评分分别为(0.88±0.03)分和(1.25±0.05)分,术后7 d分别为(0.50±0.03)分和(0.88±0.09)分;术后3 d研究组和对照组上腹疼痛评分分别为(0.94±0.03)分和(1.38±0.06)分,术后7 d分别为(0.31±0.03)分和(0.56±0.03)分;术后3、7 d,研究组上腹饱胀和上腹疼痛症状均优于对照组(P<0.05),但嗳气和恶心症状方面,两组差异无统计学意义(P>0.05);术后1周,两组溃疡直径和溃疡愈合率差异无统计学意义(P>0.05);术后4周,研究组溃疡直径和溃疡愈合率分别为(5.9±2.8)mm和(82.4±11.3)%,对照组分别为(10.6±4.6)mm和(70.2±12.2)%,研究组溃疡直径和溃疡愈合率均优于较对照组(P<0.05);两组不良反应发生率均为6.25%,差异无统计学意义(P>0.05)。结论在奥美拉唑的基础上合用铝碳酸镁能有效改善ESD术后上腹饱胀和上腹疼痛症状,并不增加不良反应,且能促进ESD术后人造溃疡的愈合,疗效较单用奥美拉唑更佳。
Objective To observe the comparative clinical efficacy of artificial ulcers after endoscopic submucosal dis section（ESD） by 2 drug treatment programs,and to provide a reference for the clinical.Methods 32 cases undertreated by ESD in the Fifth People＇s Hospital of Changshu City from March 2010 to January 2013 were selected and divid ed into control group and study group.Omeprazole treatment was adopted in16 cases of the control group base on con ventional treatment,and hydrotalcid was combined in 16 cases of the study group base on the treatment of the control group.Upper abdominal symptoms（including epigastric fullness,epigastric pain,belching and nausea） 1,3,7 day af ter operation were observed;ulcer diameter and ulcer healing rates 1,4 week after operation were observed,and inci dence of adverse reactions were compared.SPSS 17.0 statistical package was used in statistical analysis.Results Upper abdominal symptom score of epigastric fullness,epigastric pain,belching and nausea 1 day after operation in the two groups were not statistically significant（P〈0.05）.The epigastric fullness score in study group and control group were（0.88±0.03） points and（1.25±0.05） points 3 days after operation,and the score were（0.50 ±0.03） points and（0.88±0.09） points 7 days after operation;the epigastric pain score in study group and control group were（0.94 ±0.03） points and（1.38±0.06） points 3 days after operation,and the score were（0.31 ±0.03） points and（0.56±0.03） points;epigastric fullness and epigastric pain in study group were better than those in control group（P〈0.05） 3,7 days after operation;there were no significant differences in two groups of belching and nausea 3,7 days after operation（P〈0.05）.The differences of ulcer size and ulcer healing rates in two groups 1 week after operation was not statistically significant（P〈0.05）;the ulcer size and ulcer healing rates in study group were（5.9 ±2.8） mm and（82.4±11.3）% 4 weeks after operation,the ulcer size and ulcer healing rates in control group were（10.6 ±4.6） mm and（70.2±12.2）% 4 weeks after operation,the ulcer size and ulcer healing rates in study group were better than those in control group（P〈0.05）.The incidence of adverse reactions were both 6.25% in 2 groups,the difference was not statistically significant（P〈0.05）.Conclusion Omeprazole combined with hydrotalcid can improve abdominal fullness and epigastric pain after the ESD effectively,and can not increase the adverse reactions,and can promote healing of artificial ulcers after ESD,and the clinical efficacy of combination of omeprazole and hy drotalcid will be better than that of omeprazole individually.
出处
《中国医药导报》
CAS
2013年第24期65-67,70,共4页
China Medical Herald
基金
江苏省"六大人才高峰"资助项目(编号:117)
