Korean J Gastrointest Endosc > Volume 33(1); 2006 > Article
Korean Journal of Gastrointestinal Endoscopy 2006;33(1): 6-11.
내시경 지혈술을 시행받은 소화성궤양 환자에서 재출혈 예방에 대한 고용량 프로톤 펌프 억제제(PPI)의 경구 및 정맥투여의 효과 비교
장재영·주광로·황보영·정래익·최선영·정지헌·채명종·이상길·동석호·김효종·김병호·장영운·이정일·장린
경희대학교 의과대학 내과학교실
A Comparison of the Effect of High-dose Oral and Intravenous Proton Pump Inhibitor on the Prevention of Rebleeding after Endoscopic Treatment of Bleeding Peptic Ulcers
Jae Young Jang, M.D., Kwang Ro Joo, M.D., Young Hwangbo, M.D., Lae Ik Jeong, M.D., Sun Young Choi, M.D., Ji Heon Jung, M.D., Myung Jong Chae, M.D., Sang Kil Lee, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byung-Ho Kim, M.D., Young Woon Chang, M.D., Jou
Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
Abstract

Background/Aims:
The use of proton pump inhibitor (PPI) prevents rebleeding by elevating the intragastric pH in patients with bleeding peptic ulcers after hemostasis has been achieved. We assessed if high-dose oral pantoprazole is as effective as high-dose intravenous pantoprazole for their ability to prevent rebleeding after having achieved initial hemostasis in patients with active bleeding or nonbleeding visible vessels.
Methods:
Thirty eight patients with bleeding peptic ulcers who had achieved initial hemostasis were enrolled in this randomized controlled trial. In the high-dose oral pantoprazole group (n=19), 40 mg of pantoprazole was given orally twice daily for 5 days. In the high-dose intravenous pantoprazole group (n=19), an 80 mg intravenous bolus of pantoprazole was given; this was followed by 8 mg/hour of continuous infusion daily for 3 days. Thereafter, 40 mg of pantoprazole was given orally once daily for 8 weeks.
Results:
The two groups were similar with respect to all the background variables. Rebleeding occurred in 2 patients (10.5%) in the intravenous group and in 1 patient in the oral group (5.3%) by day 30 after enrollment (p=1.000). There was no significant difference in terms of the number of therapeutic endoscopic sessions (1 vs. 1.13⁑0.52), the surgery (0% vs. 0%), the bleeding related mortality (0% vs. 0%), and the mean number of units of transfused blood.
Conclusions:
The high-dose oral pantoprazole is as effective as an intravenous administration in reducing rebleeding episodes in patients with bleeding peptic ulcers after successful endoscopic therapy. (Korean J Gastrointest Endosc 2006;33:6⁣11)
Key Words: Peptic ulcer hemorrhage, Proton pump inhibitor, Oral, Intravenous
주요어: 소화성궤양 출혈, 프로톤 펌프 억제제, 경구투여, 정맥투여
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Clinical Usefulness of Proton Pump Inhibitor Intravenous Treatment in Bleeding Peptic Ulcer  2007 February;34(2)
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