Objective To systematically evaluate the effectiveness and safety of China-made omeprazole in treating acute non-variceal upper gastrointestinal bleeding. Methods Such databases as PubMed, MEDLINE, Springer, The Cochrane Library, CNKI, VIP, CBM and WanFang data were searched to collect the randomized controlled trials (RCTs) about China-made omeprazole in treating acute non-variceal upper gastrointestinal bleeding, and the references of included studies were also retrieved. The retrieval time was from inception to December 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then the meta-analysis was conducted by using RevMan 5.1 software. Results A total of 11 RCTs were included. Among all 1 075 patients, 544 were in the treatment group, while the other 531 were in the control group. The results of meta-analysis showed that, there were no significant differences in the total effective rate (OR=0.68, 95%CI 0.35 to 1.33, P=0.26) and safety (RR=1.33, 95%CI 0.45 to 3.91, P=0.96) between the China-made omeprazole and imported omeprazole. Conclusion China-made omeprazole is effective and safe in treating acute non-variceal upper gastrointestinal bleeding in comparison with the imported omeprazole.
目的:比较国产生长抑素与进口生长抑素治疗消化性溃疡出血的经济效果。方法:将120例消化性溃疡伴出血的患者随机分成国产生长抑素及进口生长抑素组,分别给予国产生长抑素、进口生长抑素治疗3天,观察疗效,并进行药物经济学评价。 结果: 国产生长抑素、进口生长抑素治疗上消化道出血成本分别为558元和4116元,有统计学差异(P＜005);有效率分别为925%和968%,无统计学差异 (Pgt;005),成本—效果比分别为60324和425207,有统计学差异(P＜005)。结论: 从药物经济学角度分析,国产生长抑素治疗消化性溃疡出血较进口生长抑素更为经济。
目的 总结经颈静脉肝内门体静脉分流术（TIPS）治疗未合并肝癌的门静脉高压症患者行脾切除术后反复上消化道出血的疗效。方法 对未合并肝癌或胆管癌的门静脉高压症合并上消化道大出血患者行脾切除术后复发出血患者行TIPS术治疗，并随访1～5年（平均3.2年）的资料进行总结与分析。结果 36例脾切除术后再出血者行TIPS术， 手术均获成功，围手术期死亡率为2.78％（1/36），死亡原因是肝性脑病。随访期间患者术后再次复发出血率为5.71％（2/35）。结论 TIPS对脾切除治疗门静脉高压症后反复出血病例的效果良好。
Objective To explore the feasibility and safety of liver transplantation （LT） in treatment of upper gastrointestinal hemorrhage in patients with portal hypertension， and to compare the therapeutic effects with conventional operation （CO）. Methods The clinical data of 303 patients with bleeding portal hypertension from Feb. 2009 to Feb. 2012 in the department of hepatobiliary and pancreatic surgery of First Affiliated Hospital of Zhejiang University were retrospectively analyzed. One hundred and one patients received LT procedure （LT group）， whereas the other 202 patients received CO procedure （CO group）. Postoperative follow-up period was 8-44 months （average 26 months）. Results Liver function before operation in CO group was significantly better than that in LT group（P＜0.01）. The mortality of CO group and LT group were 7.4%（14/189） and 3.0%（3/101， P=1.00）， respectively. The rebleeding rate of patients underwent LT was 2.0%（2/101）， significantly lower than that of CO group 〔9.5%（18/189）， P＜0.05〕. The vanish rate of esophagogastric varice in patients underwent LT was 86.1%（87/101）， significantly lower than that of CO group 〔54.5%（86/189）， P＜0.01〕. Conclusions LT treatment for bleeding portal hypertension is feasible and safe. Patients with good liver function despite hemorrhage history may be managed satisfactorily with conventional surgery. LT is the only curative treatment for patients with portal hypertension in end-stage liver disease.
目的 对上消化道异物的诊治手段及结果进行阶段总结，方便今后诊治手段的选择。方法 对1999~2006年甘肃省康泰医院收治的75例上消化道异物患者的诊断及治疗过程进行回顾性研究。结果 本组病例经保守治疗异物自行排出42例，内镜取出8例，外科手术取出25例，均取得了满意的疗效，住院期间未出现严重并发症。结论 上消化道异物的治疗措施，应依照异物具体情况选择，推荐内镜治疗为首选治疗方法。
目的总结外科手术后应激性溃疡大出血的临床特点和治疗经验。方法回顾分析1997~2003年期间我院治疗的32例应激性溃疡大出血患者的临床资料。结果28例患者采用非手术治疗，其中12例患者接受急诊胃镜检查; 手术治疗4例。本组患者总的治愈率为87.50%，死亡率为15.62%。结论急诊胃镜检查有助于明确诊断及止血治疗，应激性溃疡大出血首选非手术治疗，无效者可选择手术治疗。
目的 探讨胃切除术后近期上消化道大出血的原因及再手术治疗。 方法 对我院1986~2002年间收治的14例胃切除术后近期（24～72 h内）上消化道大出血行再手术治疗的病例资料进行回顾性分析。 结果 本组14例，术后吻合口出血4例，残胃粘膜损伤出血2例，残胃肠套叠出血2例，十二指肠残端出血1例，遗漏十二指肠球后溃疡及贲门粘膜撕裂出血各1例，原因不明出血3例，均经再次手术治疗后痊愈。 结论 胃切除术后近期上消化道大出血原因多为操作不当及病灶遗漏所致，出血灶直视下缝扎为有效止血方法。
From 1984 to 1994, 196 patients with massive upper gastrointestinal hemorrhage (hemorrhagic gastritis 137 cases, gastric ulcer 59 cases) caused by acute gastric mucosal lesions were treated in our hospital. As soon as the diagnosis was established, the stress factors in relation to acute gastric mucosal lesions and the factors damaging gastric mucosal barrier should he dispeled and hypovolemia should he corrected. In this group, the operative mortality were as follow: stress ulcer 6.3%, hemorrhagic gastritis 33.3%. According to this result, we consider that in cases of hemorrhagic gastritis the surgical operation must be considered with great care, but for stress ulcer with massive bleeding energetic surgical operation should be taken.