Objective To investigate the gastrointestinal(GI) protective effect of Omeprazole on children undergoing thoracoscopic heart surgery with cardiopulmonary bypass (CPB). Methods One hundred and twenty seven patients who were scheduled for cardiac surgery with CPB were randomly equally divided into three groups. Group A and B underwent thoracoscopic heart surgery, while the control group underwent conventional heart surgery by sternotomy. Before CPB, group A was treated with Omeprazole 10mg added to the priming solution.? Group B and the control group were treated by adding the same amount of normal saline (to the priming solution). pH and red blood cell count of gastric secretion and serum gastric level (Assay Designs ELISA) were measured at the following intervals: before CPB, 30 minutes into CPB, at termination of CPB,4 and 24 hours after termination of CPB. Results Compare to prior to CBP, the value of the gastric pH in group A was significantly higher (Plt;0.01), and that of group B was significantly lower (Plt;0.05)at the end of CPB. The same value in the control group was significantly lower (Plt;0.05)4h, after the end of CPB. Compared to prior CPB, the mean red blood cell count of gastric secretion and serum gastric level were significantly descent (Plt;0.01) in all there group post CBP. Compare to the control group, the mean gastric pH level in group A was significantly elevated at all time intervals post CBP; while the mean gastric secretin red blood cell count was significantly decreased. The mean serum level in group A 30 min post CBP was significantly lower than that in group B and the control group. Compared to the control group, the mean gastric pH level was significantly lower in group B but returned to the pre-CPB level in 24 h. The mean gastric secretin red blood cell amount and serums gastric level in group B at all time intervals were significantly decreased compare to those of the control group. Conclusion Thoracoscopic heart surgery of children with CPB
Objective To investigate the efficacy of pantoprazole and omeprazole as part of triple therapy in treatment of duodenal ulcer. Methods Seventy-eight patients with duodenal ulcer and HP-positive were randomized to two groups. A random number table was used to generate random sequence. The sequence was not concealed. No blinding was used. Thirty-nine patients received pantoprazole 40 mg + amoxicillin 1.0 g + clarithromycin 0.5 g (PAC group) and 39 patients received omeprazole 20 mg + amoxicillin 1.0 g + clarithromycin 0.5 g (OAC group), twice daily with duration of 7 days. The follow-up time was 4 to 6 weeks. Results At the end of the treatment, 38 patients completed the study, and 1 patient lost to follow-up in the PAC group; thirty-seven patients completed the study, two patients lost to followup in the OAC group. The results of intention-to-treat analysis and per-protocol analysis showed that the HP eradication rates were 87.2%/89.5% in the PAC group and 87.2%/91.9% in the OAC group (P＞0.05); the clinical improvement rates were 79.4%/81.6% in the PAC group and 82.0%/86.5% in the OAC group (P＞0.05). The side effect rates were 10.6% in the PAC group and 8.1% in the OAC group (P＞0.05). No significant difference was found between the two groups (P＞0.05). Conclusions The PAC group is therapeutically effective for eradication of HP and improves symptoms and has an equivalent effect to OAC group for patients with HP-positive duodenal ulcer. Both drugs are well tolerated.
ObjectivesTo systematically review the efficacy and safety of esomeprazole versus omeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect the randomized controlled trials (RCTs) about the efficacy and safety of esomeprazole versus omeprazole in the treatment of ANVUGIB from inception to January, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 17 RCTs involving 2 086 patients were included. The results of meta-analysis showed that, the total effective rate of esomeprazole group was higher than omeprazole group (RR=1.09, 95%CI 1.04 to 1.14, P=0.000 6), the incidence of adverse reactions was lower than omeprazole group (OR=0.27, 95%CI 0.18 to 0.40, P<0.000 01), the average hemostasis time was shorter than omeprazole group (MD=−0.64, 95%CI −0.94 to −0.34, P<0.0001), and the difference were statistically significant.ConclusionsCurrent evidence shows that in the treatment of ANVUGIB, esomeprazole has rapid hemostasis, significant effect and fewer adverse reactions, which is worthy of wide application and promotion. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.