【摘要】 目的 探讨内镜下电凝止血联合艾司奥美拉唑钠治疗消化性溃疡（PUD）出血的临床疗效。方法 将92例PUD出血患者按照患者意愿分为两组，每组46例。对照组患者采用艾司奥美拉唑钠治疗，研究组患者采用内镜下电凝止血联合艾司奥美拉唑钠治疗，均治疗5 d。比较两组患者的临床疗效、临床症状缓解时间、治疗前后凝血功能[凝血酶原时间（PT）、纤维蛋白原（FIB）水平、凝血活酶时间（APTT）及凝血酶时间（TT）]，治疗前及治疗后1个月胃酸分泌情况[基础胃酸分泌量（BAO）、最大胃酸分泌量（MAO）、高峰胃酸分泌量（PAO）]。结果 研究组患者临床疗效总有效率为91.30%，对照组患者为76.09%，研究组高于对照组（P<0.05）。治疗5 d，两组患者PT、APTT及TT较治疗前缩短，FIB水平较治疗前升高，且研究组优于对照组（P<0.01）。研究组患者腹痛、腹胀、呕血或便血及嗳气症状缓解时间短于对照组（P<0.01）。治疗后1月，两组患者BAO、MAO、PAO较治疗前减少，且研究组少于对照组（P<0.05或0.01）。结论 内镜下电凝止血联合艾司奥美拉唑钠治疗PUD出血患者效果良好，能发挥协同增效作用，快速改善临床症状，抑制胃酸分泌，保护胃肠黏膜，加速患者康复进程。更多还原

【Abstract】 Objective To explore the clinical efficacy of endoscopic electrocoagulation hemostasis(EECH) combined with esomeprazole in the treatment of peptic ulcer bleeding.Methods Ninetytwo patients with peptic ulcer bleeding were divided into two groups according to patients’ will,with46 ones in each.Controls received esomeprazole treatment and research group did the EECH plus esomeprazole,for 5 days.Such indexes were compared between two groups as clinical effects,the relief time of clinical symptoms,pre-and post-treatment coagulation functions(prothrombin time [PT],fibrinogen [FIB],activated partial thromboplastin time [APTT] and thrombin time [TT]),and gastric acid secretion(basal acid output [BAO],maximum acid output [MAO] and peak acid output [PAO])before treatment and in a month after treatment.Results The clinical total effective rate was higher in research than control group(91.30% vs.76.09%,P<0.05).After 5 day treatment,PT,APTT and TT shortened and FIB levels elevated in both groups compared with pre-treatment,and research group was superior to controls(P<0.01).Relieves of abdominal pain,abdominal distension,hematemesis or hematochezia,and belching were earlier in research than control group(P<0.01).After 1 month treatment,the BAO,MAO and PAO were lower in both groups compared with pre-treatment and so were those in research than control group(P<0.05 or 0.01).Conclusion The EECH plus esomeprazole is effective in the treatment of peptic ulcer bleeding,can play a synergistic role and improve clinical symptoms quickly,inhibit gastric acid secretion,protect gastrointestinal mucosa,and accelerate the progress of patients’ rehabilitation.更多还原