非静脉曲张上消化道大出血临床治疗探讨

探讨埃索美拉唑联合奥曲肽治疗上消化道大出血的临床疗效影响。收集莆田学院附属医院(本院)2012年8月—2014年8月急诊病房收住非食道静脉曲张的上消化道大出血病人97例为研究组,给予大剂量的埃索美拉唑联合奥曲肽治疗;收集本院2010年8月—2012年8月收住消化内科非食道静脉曲张的上消化道大出血病人102例为对照组,给予常规剂量的埃索美拉唑联合奥曲肽治疗。研究并分析两组的临床效果。结果显示,研究组临床效果91.75%,对照组临床效果70.58%,两组比较差异有统计学意义(P<0.05),说明大剂量的埃索美拉唑联合奥曲肽治疗上消化道大出血的临床效果显著。     

吸烟对十二指肠球部溃疡愈合率以及HP感染根治性治疗影响

十二指肠球部溃疡愈合率以及HP感染的根治性治疗,受多种因素影响．我们对70余名十二指肠球部溃疡患者（治疗期间未戒烟者43名,戒烟者40名）进行临床调查,以了解吸烟对十二指肠球部溃疡愈合以及HP感染根治的影响．结果表明,吸烟本身并不影响抗生素对HP的根治,但影响溃疡的病程,降低抗酸剂的疗效,故十二指肠球都溃疡患者最好在治疗期间应戒烟,至少在治疗后期坚持不吸烟。     

腹腔镜十二指肠溃疡穿孔修补12例报告

目的 评价腹腔镜修补十二指肠球部溃疡穿孔的效果。方法 对12例十二指肠球部溃疡穿孔的病人行电视腹腔镜缝合修补，观察其疗效及并发症。结果12例均在腹腔镜下成功修补，术后恢复快，平均住院6天，无手术并发症。结论 电视腹腔镜十二指肠球部溃疡穿孔修补术是安全有效的手术方法。     

消化性溃疡的二种质子泵抑制剂序贯疗法比较

目的:观察二种质子泵抑制剂序贯治疗消化性溃疡的临床疗效.方法:300例患者随机分成两组,治疗组150例,给予埃索美拉唑镁联合替普瑞酮、克拉霉素、阿莫西林口服;对照组给予奥美拉唑联合替普瑞酮、克拉霉素、阿莫西林口服.疗程为4周.根据临床症状和胃镜检查结果进行统计学分析处理.结果:临床症状和胃镜检查结果,治疗组优于对照组P<0.01.     

胃十二指肠溃疡穿孔128例治疗体会

胃十二指肠溃疡穿孔是外科常见的急腹症,1986年至1994年5月,我院外科治疗胃十二指肠溃疡穿孔128例,总结如下: 临床资料 1.1 一般资料:本组128例,其中十二指肠溃疡穿孔70例,男66例,女4例,年龄14～56岁,十二指肠球部前壁,距幽门1cm处穿孔68例,降部外侧壁穿孔2例。胃溃疡穿孔58例,男53例,女5例,年龄28～69岁,     

雷尼替丁治疗十二指肠球部溃疡近期疗效分析

本文作者应用第二代H_2受体拮抗剂雷尼替丁对144例十二指肠球部溃疡患者进行治疗，获得良好的疗效，6周末治愈率为85．42％。其副作用极为轻微。     

修补加H_2受体阻滞剂治疗十二指肠溃疡穿孔45例体会

我科自1988年—1992年共收治溃疡病穿孔患者95例,其中十二指肠球部溃疡穿孔60例,采用修补加H_2受体阻滞剂治疗45例,现将治疗结果及体会报告如下:     

溃疡病并存胆囊结石8例

溃疡病并存胆囊结石比较少见。80年至85年我们吸治的溃疡病246例中并存胆囊结石8例,就其诊断、治疗介绍如下: 一、一般资材男性6例,女性2例,50岁至56岁6例,72岁1例,30岁1例。典型溃疡病史10年至20年,均经过长期的药物治疗。经胃镜、X线钡餐透视检查,十二指肠球部溃疡7例,胃角部溃疡1例,4例有活动性龛影均在1.5cm以上,2例球部变形,功能激惹。     

儿童胃镜检查48例临床分析

总结分析我院自2002年11月至2005年6月对48例10—14岁儿童上消化系统疾病进行纤维胃镜检查的资料。结果表明:儿童上消化系统疾病以慢性浅表性胃炎和十二指肠球部溃疡最常见,对有疑诊者应早期作胃镜检查,及时治疗。     

不容忽视的中学生消化道溃疡

最近，我在消化道专家门诊连续诊治二例上消化道出血的中学生。一例１７岁男孩，平时饥饿时偶感胃部不适，就诊前出现黑便，每日１—２次，当感到乏力、头晕时方来院就诊。查体见明显贫血貌，血色素７．３g％，余未见异常。另一例为１４岁男孩，平时症状不多，拉暗红色大便二天，就诊时血色素８．７g％。既往曾有类似出血史。两例经胃镜确诊：十二指肠球部溃疡。消化性溃疡是指胃肠黏膜被胃液消化形成的溃疡，可发生于食管、胃、十二指肠、胃———空肠吻合口和含有胃黏膜的Meckel憩室。本病发病原因不十分清楚，但与胃酸及胃蛋白酶多、吸…     

中西医结合治疗HP阳性慢性胃炎疗效观察

目的观察中药胃复春联合奥美拉唑、阿莫西林及克拉霉素标准三联疗法治疗幽门螺杆菌（Hp）阳性慢性胃炎的临床疗效及用药安全性。方法将100例Hp阳性的慢性胃炎患者随机分成两组,两组患者均先口服奥美拉唑、阿莫西林及克拉霉素治疗7d,之后用奥美拉唑治疗35d。治疗组加用胃复春,对照组不用。疗程结束后4周复查胃镜,行Hp检测并评价临床疗效。结果两组临床疗效比较,差异有统计学意义（P〈0．01）;两组Hp阴转率比较,差异有统计学意义（P〈0．01）。结论胃复春联合奥美拉唑、阿莫西林及克拉霉素标准三联疗法治疗Hp阳性的慢性胃炎疗效显著,Hp阴转率较高,不良反应少,有较高的临床应用价值。     

Early effects of oral administration of omeprazole and roxatidine on intragastric pH

Objective

The ideal medication for the treatment of acid-related diseases, e.g., peptic ulcers, stress-related gastric bleeding, functional dyspepsia, and gastroesophageal reflux disease, should have a rapid onset of action to promote hemostasis and relieve the symptoms. The aim of our study was to investigate the inhibitory effects on gastric acid secretion of a single oral administration of a proton pump inhibitor, omeprazole 20 mg, and an H₂-receptor antagonist, roxatidine 75 mg.

Methods

Ten Helicobacter pylori-negative male subjects participated in this randomized, two-way crossover study. Intragastric pH was monitored continuously for 6 h after single oral administration of omeprazole 20 mg and roxatidine 75 mg. Each administration was separated by a 7-d washout period.

Results

During the 6-h study period, the average pH after administration of roxatidine was higher than that after administration of omeprazole (median: 4.45 vs. 2.65; P=0.0367). Also during the 6-h study period, a longer duration of maintenance at pH above 2, 5, and 6 was observed after administration of roxatidine 75 mg than after administration of omeprazole 20 mg (median: 90.6% vs. 55.2%, P=0.0284; 43.7% vs. 10.6%, P=0.0125; 40.3% vs. 3.3%, P=0.0125; respectively).

Conclusions

In Helicobacter pylori-negative healthy male subjects, oral administration of roxatidine 75 mg increased the intragastric pH more rapidly than that of omeprazole 20 mg.     

奥美拉唑联合阿莫西林和呋喃唑酮治疗幽门螺杆菌感染临床分析

目的 :观察奥美拉唑联合阿莫西林和呋喃唑酮治疗幽门螺杆菌感染的效果 .方法 :将2 4 0病例随机分为两组 .治疗组采用奥美拉唑联合阿莫西林和呋喃唑酮 (简称奥组 ) ,对照组采用果胶铋联合阿莫西林和甲硝唑 ,疗程两周 .结果 :治疗组和对照组HP根除率分别为96 7%和 6 8 3% ,溃疡及糜烂面愈合率分别为 90 0 %和 6 1 7% ,两组差异有显著性意义 (P <0 0 1) .结论 :奥美拉唑联合阿莫西林和呋喃唑酮是目前一种理想的根除HP治愈溃疡及糜烂面的方案 .     

口服理中丸联合艾灸中脘治疗脾胃虚寒型功能性消化不良临床观察

目的观察口服理中丸联合艾灸中脘治疗脾胃虚寒型功能性消化不良的临床疗效。方法将64例脾胃虚寒型功能性消化不良患者随机分为治疗组和对照组,治疗组口服理中丸配合艾灸中脘;对照组静滴奥美拉唑针,口服多潘立酮片。治疗2周后记录治疗前后患者的中医证候评分,评价临床疗效。结果治疗组总有效率为87.50%,对照组总有效率为71.88%,两组疗效比较,治疗组优于对照组,差异有统计学意义(P<0.05)。结论采用口服理中丸配合艾灸中脘的方法治疗脾胃虚塞型FD优于静滴奥美拉唑针、口服多潘立酮片的治疗效果。     

枸橼酸铋钾联合克拉霉素和替硝唑根除幽门螺旋杆菌感染临床分析

目的 :观察枸橼酸铋钾联合克拉霉素和替硝唑根除幽门螺旋杆菌 (HP)感染的疗效。方法 :将12 2例幽门螺旋杆菌阳性的消化性溃疡病人随机分为两组 :治疗组用枸橼酸铋钾联合克拉霉素和替硝唑短程治疗一周 ;对照组用奥美拉唑联合头孢羟氨苄和甲硝唑治疗二周。结果 :治疗组和对照组的HP根除率分别为 83 9%和 85 % ,溃疡愈合率分别为 85 5 %和 88 3% (p >0 0 5 )。结论 :枸橼酸铋钾联合克拉霉素和替硝唑能有效根除HP ,促进溃疡愈合 ,且不良反应少 ,疗程短 ,经费低 ,病人顺从性好 ,值得推广     

老年性消化性溃疡并出血患者胃镜下止血治疗的临床疗效分析

目的:探讨胃镜下止血治疗老年性消化性溃疡并出血的临床疗效。方法:选择144例老年性消化性溃疡并出血的患者,随机分为2组:甲组80例采用胃镜下喷洒和或注射止血治疗;乙组64例予以每天2次静脉滴注奥美拉唑40mg,疗程5天。治疗期间记录病人的72h治疗成功率、再出血率、止血时间、住院天数作为疗效判断指标。结果:72h治疗成功率分别为87.5%(70)、50.0%(32);再出血率分别为6.25%(5)、26.6%(17);止血时间(h)分别为46.2±14.5、86.8±19.4;住院天数(d)分别为15.8±2.0、24.1±4.2,甲乙两组比较均有显著性差异(P<0.05)。结论:胃镜下止血治疗老年出血性消化性溃疡的临床疗效较内科治疗更满意,值得临床推广应用。     

Relative bioavailability and pharmacokinetic comparison of two different enteric formulations of omeprazole

In order to comply with the requirements for a drug listed in China, the study was developed to compare the pharmacokinetics and relative bioavailability of two different enteric formulations of omeprazole (OPZ) in healthy Chinese subjects. A total of 32 volunteers participated in the study. Plasma concentrations were analyzed by nonstereospecific liquid chromatography/tandem mass spectrometric (LC-MS/MS) method. After administration of a single 40-mg dose of the two OPZ formulations, the comparative bioavailability was assessed by calculating individual AUC_0−t (the area under the concentration-time curve from time zero to the last measurable concentration), AUC_0−∞ (the area under the concentration-time curve extrapolated to infinity), C _max (the maximum observed concentration), and T _peak (the time to C _max) values of OPZ, 5-hydroxyomeprazole (OH-OPZ), and omeprazole sulfone (OPZ-SFN), respectively. The 90% confidence intervals (CIs) of AUC_0−t , AUC_0−∞, and C _max were 85.4%–99.0%/88.8%–98.6%/87.6%–99.4%, 85.5%–99.2%/89.0%–98.6%/88.5%–101.3%, and 72.3%–87.6%/79.6%–91.1%/88.4%–99.1% for OPZ/OH-OPZ/OPZ-SFN, respectively, and T _peak values did not differ significantly. In this study, the test formulation of OPZ in fasting healthy Chinese male volunteers met the Chinese bioequivalance standard to the reference formulation based on AUC, C _max, and T _peak.     

呋喃唑酮、法莫替丁、乐得胃联合治疗十二指肠溃疡临床观察

目的:探求适用于低收入人群十二指肠溃疡(DU)患者经济、有效的治疗方案。方法:将156例活动性DU患者随机分成2组,治疗组82例,用呋喃唑酮200mg、乐得胃2片每天三次,法莫替丁20mg早晚各一次治疗2周:对照组74例,用羟氨苄青霉素500mg、胶体果胶铋100mg(以Bi计)每天三次,奥美拉唑40mg每天早晨一次治疗2周,疗程结束时复查胃镜观察溃疡愈合情况,疗程结束后4周取胃粘膜检查幽门螺杆菌(HP),观察HP根除情况。结果:治疗组和对照组对DU有效率分别为93.6％和94.5％,无统计学差异(P>0.05),HP根除率分别为82.3％和95.7％,对照组明显高于治疗组(P<0.01);治疗组2例出现白细胞轻度降低(3.5×10~9/L),对照组1例ALT轻度升高,治疗结束后均恢复,余无严重不良反应。呋喃唑酮、乐得胃、法莫替丁联合治疗DU,虽然HP根除率稍低,但经济、安全、有效,尤其适用于低收入患者。     

The relationship between ulcer recurrence andHelicobacter pylori: A prospective one-year follow-up study in China

To study the relationship between ulcer recurrence andHelicobacter Pylori. 147 patients with peptic ulcer were divided intoH. Pylori infected group andH. pylori uninfected group by rapid urease test serum antibody examination and histopathology of gastric biopsy specimens. We assigned all patients to receive dual oral therapy with omeprazole 40 mg/day for 4 weeks and amoxicillin 2000 mg/day for 2 weeks. To all patients, repeated gastroscope was performed at 8 weeks and one-year after beginning therapy to record whether the ulcer was cured. Endoscopic biopsy was also performed to determineH. pylori status. One year later,H. pylori positive patients had a higher ulcer recurrent rate thanH. pylori negative patients (23. 33% vs 2. 70%; P=0.001). Ulcer recurrence was closely related toH. pylori infection.H. pylori was the risk factor for ulcer relapse.     

巴陵名称由来探究

巴陵名称由来素有4种说法：神话传说说、巴子国陵墓说、刘巴墓说与山势说。其中二、三种说法据证不足,不能成立;第一种说法属于附会;只有山势说才是真正的源头。