胃大部切除术后吻合口溃疡并出血反复发作临床观察.docVIP

胃大部切除术后吻合口溃疡并出血反复发作临床观察 　　【摘 要】目的 探讨胃大部切除术后吻合口溃疡并出血反复发作的临床特点及预防治疗效果。方法 选取笔者所在医院曾住院治疗过的胃大部切除术后吻合口溃疡并出血治愈后1年内反复再出血的患者42例，（治愈标准为术后初次出血治疗后胃镜下溃疡达瘢痕期）。随机分为观察组和治疗组，每组各21例。观察组仅常规应用对症处理的药物，治疗组按照既往高发季节预防性服用雷贝拉唑钠肠溶片。结果 观察组复发率38.1%，治疗组复发率4.7%。两组比较差异有统计学意义（P0.05）。结论 预防性应用雷贝拉唑钠肠溶片可明显减少胃大部切除术后吻合口溃疡合并出血反复发作，且费用小、服药方便、药物亦获得，适合在临床中推广应用。 　　【关键词】胃大部切除术后；吻合口溃疡并出血；复发率；雷贝拉唑肠溶片 　　Abstract：Objective To investigate the subtotal gastrectomy postoperative anastomotic ulcer bleeding clinical characteristics and prevention and treatment effect of recurrent.Methods the hospital hospitalizedgastrectomy treated resection anastomotic ulcer and hemorrhage in 42 cases cured within 1 years after the repeated hemorrhage（bleedingpatients，cure standard for the treatment of the first postoperative ulcerscar period under gastroscope up）.Were randomly divided into the observation group and treatment group，21 cases in each group.Observation of drug group only routine use of symptomatic treatment，the treatment group in accordance with the previous season of high incidence of prophylactic use of Rabeprazole Sodium Enteric-coated Tablets.Results in the observation group，recurrence rate was 38.1% in treatment group，the recurrence rate 4.7%.There was significant difference between two groups（P0.05）.The preventive application of Rabeprazole Sodium Enteric-coated Tablets can significantly reduce thesubtotal gastrectomy postoperative anastomotic ulcer complicated with hemorrhage recurrent episodes，and the cost is small，convenient taking，drug obtained，suitable for clinical application. 　　Keywords：After subtotal gastrectomy Anastomotic ulcer and bleeding The recurrence rate Ray Bella triazole enteric coated tablets 　　吻合口溃疡是胃大部切除术后较多见远期并发症。近几年来吻合口溃疡并出血占我国上消化道出血的比例明显增加。[1]反复的吻合口溃疡并出血严重地影响了患者的生活质量，增加患者的心理负担，因此如何预防胃大部切除术后吻合口溃疡并出血的反复发作，一直困扰着临床医生和患者。本研究收集了2007年1月至2013 年1月于我院消化内科住院治疗的吻合口溃疡并出血的患者。旨在通过观察其临床特点、预防用药效果，为胃大部切除术后吻合口溃疡反复出血的患者治疗提供参考。 　　1对象与方法 　　1.1临床资料 选取2007年1月至2013年1月于我院消化内科曾住院治疗的吻合口溃疡并出血治愈后（镜下溃疡达瘢痕期）1年内反复再出