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急性非静脉曲张性上消化道出血高危病变内镜止血术后静脉注射与大剂量口服质子泵抑制剂治疗的比较

Intravenous versus high-dose oral proton pump inhibitor therapy after endoscopic hemostasis of high-risk lesions in patients with acute nonvariceal upper gastrointestinal bleeding.

作者信息

Murthy Sanjay, Keyvani Leila, Leeson Shauna, Targownik Laura E

机构信息

Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

Dig Dis Sci. 2007 Jul;52(7):1685-90. doi: 10.1007/s10620-006-9684-1. Epub 2007 Mar 24.

Abstract

Intravenous proton pump inhibitors (IV PPIs) decrease rebleeding following endoscopic hemostasis of bleeding peptic ulcers. Oral PPIs may be equally efficacious and may significantly reduce health care costs. This study aimed to compare outcomes in patients receiving oral versus IV PPI therapy following endoscopic hemostasis in patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB). We performed a retrospective review of all patients who received PPI therapy following endoscopic hemostasis for ANVUGIB. The primary outcome was the adverse gastrointestinal event rate. One hundred sixty-two patients met the entry criteria (72 oral PPIs, 90 IV PPIs). The difference in the rate of adverse gastrointestinal events between the two groups was 1% (P = 0.85). Postendoscopic IV PPI use was associated with an odds ratio of 1.01 for developing an adverse outcome versus oral PPIs (95% CI: 0.44-2.33). We conclude that oral PPIs are probably equivalent to IV PPIs for preventing rebleeding in ANVUGIB patients.

摘要

静脉质子泵抑制剂(IV PPIs)可减少消化性溃疡出血内镜止血后的再出血。口服质子泵抑制剂(PPIs)可能同样有效,且可显著降低医疗成本。本研究旨在比较急性非静脉曲张性上消化道出血(ANVUGIB)患者内镜止血后接受口服与静脉PPI治疗的疗效。我们对所有接受ANVUGIB内镜止血后PPI治疗的患者进行了回顾性研究。主要结局是不良胃肠道事件发生率。162例患者符合纳入标准(72例口服PPIs,90例静脉PPIs)。两组不良胃肠道事件发生率的差异为1%(P = 0.85)。内镜检查后使用静脉PPI与口服PPIs相比,发生不良结局的比值比为1.01(95%CI:0.44 - 至2.33)。我们得出结论,口服PPIs在预防ANVUGIB患者再出血方面可能与静脉PPIs等效。

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