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Peptic ulcer bleeding (PUB) accounts for the proportion of acute nonvenous upper gastrointestinal bleeding, which is still a common medical emergency with high morbidity and mortality.
With the development of endoscopic hemostase and proton pump inhibitors (PPIs), pub's prognosis has changed over the past few decades, so the latest guidelines from the International Consensus Group recommend high-dose PPI treatment for patients receiving endoscopic hemostase, i.e. intravenous injections, followed by continuous infusions (80 mg, then 8 mg / hr) for 72 hours, but the optimal dose of PPI after endoscopic hemostrapy remains controversial.
, this study aims to compare the efficacy of proton pump inhibitors in large doses (HD-IVP) and standard doses (SD-IVP).
reviewed data from 346 patients with endoscopic hemorrhage and high-risk bleeding at their medical center between March 2014 and September 2018 and divided them into HD-IVP and SD-IVP groups.
bias score matching analysis is used to control selection bias and other potential confuse factors.
calculated the relapsed blood rate based on the Glasgow-Bracchford score (GBS).
, the study included 346 patients who met the criteria for selection, including 89 patients in the SD-IVP group and 89 patients in the HD-IVP group who were compared in all baseline characteristics.
GBS s 8 is the best critical point for determining high-risk re-bleeding patients (GBS≥8), with significant differences in recurrence rates between SD-IVP (17/61, 27.9%) and HD-IVP (7/65,10.8%). There was no difference in recurrence rates (2/28, 7.1%) and HD-IVP (2/24, 8.3%) for patients with low-risk rehamordation (GBS -lt;8), SD-IVP (2/28, 8.3%).
study found that the best threshold for identifying hemorrhagic ulcers and high-risk stigma after endoscopic hemorrhage in high-risk and low-risk re-bleeding patients was GBS s8.
although HD-IVP was more effective than SD-IVP in high-risk patients, the effect of dose differences was not significant in low-risk patients.