Korean J Gastrointest Endosc > Volume 34(2); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;34(2): 71-75.
출혈성 궤양 치료에서 내시경 지혈술과 PPI 주사의 유용성
이항락 · 한동수 · 손병관 · 이오영 · 전용철 · 손주현 · 윤병철 · 최호순 · 함준수 · 김진배*
한양대학교 의과대학 내과학교실, *한림대학교 의과대학 내과학교실
Clinical Usefulness of Proton Pump Inhibitor Intravenous Treatment in Bleeding Peptic Ulcer
Hang Lak Lee, M.D., Dong Soo Han, M.D., Byoung Kwan Son, M.D., Oh Young Lee, M.D., Yong Chul Jeon, M.D., Ju Hyun Sohn, M.D., Byung Chul Yoon, M.D., Ho Soon Choi, M.D., Joon Soo Hahm, M.D. and Jin Bae Kim, M.D.*
Department of Internal Medicine, Hanyang University College of Medicine, *Hallym University Kangnam Hospital, Seoul, Korea

Recently, high dose PPI intravenous (IV) infusion after endoscopic hemostasis was found to decrease the recurrent bleeding rate. Therefore, we conducted this study to define the effect of endoscopic hemoclipping with PPI IV infusion on the recurrent bleeding rate.
We conducted a double-blinded prospective randomized control study. A total of 35 patients were endoscopically diagnosed with bleeding peptic ulcer of Forrest classification Ia, Ib, IIa between Jan. 2003 and Sep. 2003 in our hospital. We carried out epinephrine injection therapy around the ulcer, followed by hemoclipping at the exposed vessel. After controlling for endoscopic bleeding, we randomly divided the patients into two groups. One group received a PPI IV infusion (pantoprazole 80 mg/day) and the other group received a placebo for three days.
Only one PPI IV-infused patient and one patient receiving placebo showed recurrent bleeding at two days after endoscopic therapy. The PPI IV infusion group showed 100% (17/17) initial hemostatic rate, 5.8% (1/17) recurrent bleeding rate within 3 days, 0% (0/17) recurrent bleeding rate after 3 days, and 0% (0/17) complication rate. For these same values, the placebo group showed 100% (18/18), 5.5% (1/18), 0% (0/18), and 0% (0/18), respectively.
PPI IV infusion showed no addictive hemostatic effect. We think hemoclipping is a very effective hemostatic method, and PPI IV infusion may not be required after appropriate endoscopic management.
Key Words: Peptic ulcer bleeding, Hemoclipping, Proton pump inhibitor
주요어: 출혈성 궤양, 지혈클립, 양자 펌프 억제제
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