Erschienen in:
01.12.2007 | Original Paper
Oral Proton Pump Inhibitors Are as Effective as Endoscopic Treatment for Bleeding Peptic Ulcer: A Prospective, Randomized, Controlled Trial
verfasst von:
Jin II Kim, Dae Young Cheung, Se Hyun Cho, Soo-Heon Park, Joon-Yeol Han, Jae Kwang Kim, Sok Won Han, Kyu Yong Choi, In Sik Chung
Erschienen in:
Digestive Diseases and Sciences
|
Ausgabe 12/2007
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Abstract
In managing patients with bleeding peptic ulcers, it has been reported that pharmacologic treatment can be an alternative to endoscopic treatment. We compared the hemostasis rates of the endoscopic treatment, hemoclipping, and the phamacologic treatment, oral proton pump inhibitors (PPIs), in bleeding peptic ulcer. A randomized prospective study was performed on 129 bleeding peptic ulcer patients with hematemesis or melena. Sixty-two patients were treated by endoscopic hemoclipping and subsequently H2 receptor antagonists were injected intravenously (hemoclipping group), and 67 patients were treated with an oral PPI without endoscopic treatment (PPI group). The 24-hr gastric pH test was performed sequentially following the treatment. The initial hemostasis rate of the hemoclipping group was 93.5% (58/62) and the rebleeding rate was 6.9% (4/58), and the hemostasis rate of the PPI group was 92.5% (62/67) and the rebleeding rate was 7.5% (5/67), which were not different. The 24-hr gastric pH was 4.54 ± 2.56 in the hemoclipping group and 5.97 ± 1.30 in the PPI group (P < 0.037). In the bleeding peptic ulcer patients, the hemostasis rate with the oral administration of PPIs was not different from that with the endoscopic hemoclipping treatment.