Fusamoto H, Kawano S, Tsuji S, Oshita M, Nagano K, Ohmae A, Sawaoka H, Nagai Y, Kasahara A, Sugimoto T, Kamada T
First Department of Medicine, Osaka University School of Medicine, Japan.
Hepatogastroenterology. 1996 Jan-Feb;43(7):169-73.
BACKGROUND/AIMS: In this retrospective study, we compared the effects of histamine H2-receptor antagonists to those of antacids and anticholinergics in patients with hemorrhagic ulcers with various endoscopic appearances of bleeding.
Patients with hemorrhagic ulcers (n = 376) were examined by emergency endoscopy and were treated with 1) antacids and anticholinergic drugs or 2) H2-receptor antagonists.
In ulcer patients with oozing or fresh red coagulation, H2-receptor antagonists ceased further hemorrhage more effectively (65.9% of the cases) than antacids and anticholinergic drugs (46.7%). In patients with projectile bleeding, both of the treatments failed to stop hemorrhage. There were no significant differences in favorable outcome in the patients only with old black coagulation between antacid and anticholinergic drugs-treated group and H2-receptor antagonists-treated group (94.4% and 93.8%, respectively).
The results suggest that H2-receptor antagonists are more effective than antacids and anticholinergic drugs in patents with peptic ulcer with fresh coagulation or oozing, but not with projectile bleeding or old black coagulation. The results also indicate that endoscopic appearances of peptic ulcer bleeding are good predictors for the effects of medication.
背景/目的：在这项回顾性研究中，我们比较了组胺H2受体拮抗剂与抗酸剂和抗胆碱能药物对具有各种内镜下出血表现的出血性溃疡患者的疗效。
对出血性溃疡患者（n = 376）进行急诊内镜检查，并给予以下治疗：1）抗酸剂和抗胆碱能药物；2）H2受体拮抗剂。
在渗血或新鲜红色凝血的溃疡患者中，H2受体拮抗剂比抗酸剂和抗胆碱能药物更有效地止住进一步出血（65.9%的病例）（46.7%）。在喷射性出血的患者中，两种治疗均未能止血。仅存在陈旧性黑色凝血的患者中，抗酸剂和抗胆碱能药物治疗组与H2受体拮抗剂治疗组的良好结局无显著差异（分别为94.4%和93.8%）。
结果表明，在有新鲜凝血或渗血的消化性溃疡患者中，H2受体拮抗剂比抗酸剂和抗胆碱能药物更有效，但对喷射性出血或陈旧性黑色凝血无效。结果还表明，消化性溃疡出血的内镜表现是药物疗效的良好预测指标。
Zotero 插件