Comparison of Hemostatic Effects between a Combination Therapy Including Endoscopic Injection Therapy and Omeprazole and a Single Intravenous Omeprazole Therapy in Patients with Bleeding Peptic Ulcers.
- Author:
Seon Hee LIM
1
;
Nayoung KIM
;
Kye Heui LEE
Author Information
1. Seoul National University Hospital, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul, Korea. lshim3@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Omeprazole;
Peptic ulcer bleeding;
Endoscopic injection therapy
- MeSH:
Epinephrine;
Ethanol;
Hemorrhage*;
Humans;
Length of Stay;
Omeprazole*;
Peptic Ulcer*;
Ulcer
- From:Korean Journal of Gastrointestinal Endoscopy
2005;31(4):221-228
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: This study was performed to test whether there is some difference between combined endoscopic therapy with PPI infusion and intravenous PPI therapy alone. METHODS: A total of seventy-three high-risk patients with ulcer bleeding and non-bleeding visible vessels or fresh adherent clots resistant to irrigation were randomized to medical therapy [intravenous omeprazole therapy alone: 40 mg IV per day for 3~5 days] or to endoscopic combination therapy [endoscopic epinephrine (1 : 10,000 in normal saline) or ethanol injection followed by intravenous omeprazole infusion]. RESULTS: Patients were similar at study entry. Ulcer bleeding recurred in two patients who received combined endoscopic therapy (2/35, 5.7%) while ulcer bleeding recurred in ten patients who received intravenous omeprazole alone (10/38, 26.3%) (p < 0.05). Two patients (2/35, 5.7%) in the combined therapy group and five patients (5/38, 13.2%) in the omeprazole infusion alone group had surgery for intractable bleeding (p=0.281). One patient in each group died within the hospital stays (p=0.953). CONCLUSIONS: The combination of endoscopic injection therapy with omeprazole infusion is superior to omeprazole infusion alone for preventing recurrent bleeding from ulcers with nonbleeding visible vessels or adherent clots.
