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目的探讨尖吻蝮蛇血凝酶联合奥美拉唑治疗重型颅脑损伤继发的应激性胃粘膜病变的临床疗效。方法选取继发应激性胃粘膜病变的60例重型颅脑损伤患者,随机分为对照组(30例,单纯应用奥美拉唑)和观察组(30例,联合应用尖吻蝮蛇血凝酶和奥美拉唑)。24 h内消化道出血停止为显效,24~72 h出血停止为有效,72 h以上仍有出血为无效;总有效率=(显效+有效)/总例数。结果观察组显效20例(66.7%),有效8例,无效2例;总有效率为93.3%。对照组显效9例(30.0%),有效16例,无效5例;总有效率为83.3%。两组显效率差异有统计学意义(P<0.01),但总有效率无统计学差异(P>0.05)。结论联合应用奥美拉唑和尖吻蝮蛇血凝酶可明显缩短重型颅脑损伤继发的应激性胃粘膜病变患者消化道出血持续时间,从而减少质子泵抑制剂使用时间。
Objective To investigate the clinical efficacy of Agkistrodon acutus serogroups and omeprazole in the treatment of stress gastric mucosal lesions secondary to severe craniocerebral injury. Methods Sixty patients with severe craniocerebral injury who had secondary stress gastric mucosal lesions were randomly divided into control group (n = 30), omeprazole alone group (n = 30) and observation group (n = 30) Enzymes and omeprazole). 24 h of gastrointestinal bleeding stopped for the marked effect, 24 to 72 h stop bleeding effectively, more than 72 h still bleeding is invalid; total effective rate = (effective + effective) / total number of cases. Results The observation group was effective in 20 cases (66.7%), effective in 8 cases, ineffective in 2 cases; the total effective rate was 93.3%. In the control group, 9 cases (30.0%) were markedly effective, 16 cases were effective and 5 cases were ineffective. The total effective rate was 83.3%. Significant difference between the two groups was statistically significant (P <0.01), but the total effective rate was no significant difference (P> 0.05). Conclusions Combination of omeprazole and Agkistrodon halysii can shorten the duration of gastrointestinal bleeding in patients with stress gastric mucosal lesions secondary to severe craniocerebral injury and thus reduce the proton pump inhibitor use time.