标题：消化内镜联合泮托拉唑静脉滴注治疗消化性溃疡出血的疗效及对机体应激反应的影响

      作者：董旺黎 1，杨春娟 1，张莉静 2    1.陕西省康复医院内科，陕西 西安 710065；2.陕西省第四人民医院消化内科，陕西 西安 710043

      卷次： 2023年34卷8期

      【摘要】 目的 探究消化内镜联合泮托拉唑对消化性溃疡(PUD)出血的治疗效果。方法 将2019年5月至2021年5月期间陕西省康复医院收治的80例PUD出血患者采用随机数表法分为联合组和对照组，每组40例。联合组患者采用泮托拉唑联合内镜下止血术治疗，对照组患者采用泮托拉唑治疗，两组均治疗1个月。治疗结束后比较两组患者的临床疗效，并比较两组治疗前后的机体应激反应和胃功能，随访6个月，观察两组患者的不良反应发生情况。结果 联合组患者的临床治疗总有效率为 95.00%，明显高于对照组的 75.00%，差异有统计学意义(P<0.05)；治疗后，两组患者的超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、总抗氧化能力(T-AOC)、PGR(PGⅠ/PGⅡ)、胃泌素17 (G-17)均升高，且联合组明显高于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的丙二醛(MDA)、胃蛋白酶原Ⅰ (PGⅠ)、胃蛋白酶原Ⅱ (PGⅡ)均降低，且联合组明显低于对照组，差异均有统计学意义(P<0.05)；联合组患者的不良反应总发生率为 12.50% ，略高于对照组的 10.00%，但差异无统计学意义(P>0.05)。结论 消化内镜联合泮托拉唑静脉滴注治疗PUD出血患者疗效确切，止血效果更好，可以减轻机体应激反应，提高胃功能，且具有良好的安全性。
      【关键词】 消化性溃疡；出血；消化内镜；泮托拉唑；机体应激
      【中图分类号】 R573.1 【文献标识码】 A 【文章编号】 1003—6350（2023）08—1092—04

Efficacy of gastrointestinal endoscopy combined with pantoprazole intravenous drip in the treatment of bleedingin peptic ulcer disease and the influence on body stress response.
DONG Wang-li 1, YANG Chun-juan 1, ZHANGLi-jing 2. 1. Department of Internal Medicine, Shaanxi Rehabilitation Hospital, Xi'an 710065, Shaanxi, CHINA; 2. Departmentof Gastroenterology, the Fourth People's Hospital of Shaanxi, Xi'an 710043, Shaanxi, CHINA
【Abstract】 Objective To investigate the therapeutic effect of gastrointestinal endoscopy combined with panto-prazole on bleeding in peptic ulcer disease (PUD). Methods A total of 80 patients with PUD bleeding who were admit-ted to Shaanxi Rehabilitation Hospital from May 2019 to May 2021 were divided into the combination group and thecontrol group by random number table method, with 40 patients in each group. The combination group was treated withpantoprazole combined with endoscopic hemostasis, while the control group was treated with pantoprazole. Both groupswere treated for 1 month. The two groups were compared in terms of clinical effect after treatment, body stress response,and gastric function before and after treatment. The patients were followed up for 6 months to observe the occurrence ofadverse reactions in the two groups. Results The total clinical treatment response rate in the combination group wassignificantly higher than that in the control group (95.00% vs 75.00%, P<0.05). After treatment, the levels of superoxidedismutase (SOD), glutathione peroxidase (GSH-PX), total antioxidant capacity (T-AOC), PGR (PGⅠ/PGⅡ), and gas-trin 17 (G-17) increased, and the levels in the combination group were significantly higher than those in the controlgroup (P<0.05). The levels of malondialdehyde (MDA), pepsinogen Ⅰ (PGⅠ), and pepsinogen Ⅱ (PGⅡ) decreased,and the levels in the combination group were significantly lower than those in the control group (P<0.05). There wasno significant difference in the incidence of adverse reactions between the two groups (12.50% vs 10.00%, P>0.05).Conclusion Gastrointestinal endoscopy combined with pantoprazole intravenous drip is effective in the treatment ofpatients with PUD bleeding, with better hemostatic effect. The combined treatment can reduce body stress response andimprove gastric function, with good safety.
      【Key words】 Peptic ulcer; Bleeding; Gastrointestinal endoscopy; Pantoprazole; Body stress response