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Relaisson-a "good partner" after endoscopic treatment

Relaisson-a "good partner" after endoscopic treatment

  • Categories:Stomach healthy
  • Author:
  • Origin:
  • Time of issue:2020-12-03
  • Views:0

(Summary description)

Relaisson-a "good partner" after endoscopic treatment

(Summary description)

  • Categories:Stomach healthy
  • Author:
  • Origin:
  • Time of issue:2020-12-03
  • Views:0
Information

  Preface

  Endoscopic submucosal dissection (ESD) is a very effective surgical method for the treatment of early cancer. It can remove larger lesions than conventional endoscopic mucosal resection (EMR), but it can cause iatrogenic ulcers. Acid inhibitors for treatment. H2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) are two commonly used acid inhibitors. When PPI is used for peptic ulcers, the spread of fibrosis leads to the rapid growth of granulation tissue and causes the basal protrusion of the ulcer; PPI treatment for iatrogenic ulcers caused after surgery will prompt the rapid contraction of local tissues, leading to rapid healing of the ulcers, resulting in more serious basal protrusions of the ulcers. Although it is different from cancer recurrence, it will cause patients’ concerns. Therefore, ESD-induced It is very important that the ulcer has no basal protrusion. Polyprezinc (Polaprezinc, PZ), whose chemical structure is shown in Figure 1, is widely used in clinical treatment of gastric ulcers. It promotes ulcer healing through prostaglandin-independent mucosal protection, antioxidant function and membrane stabilization. Polyprezinc induces IGF-I synthesis, promotes the repair of mucosal deficiency through endothelial cells, and helps improve the quality of ulcer healing. This article describes the effect of PPI on the basal protrusion of the ulcer after ESD, and the improvement of the quality of ulcer healing by PPI + mucosal protective agent polyprezinc.

  1 Materials and methods

  1.1 Research objects

  165 patients were enrolled. The same doctor underwent ESD from January 2005 to August 2008. The specimens were collected for histological scoring, and the mucosa around the injury was scored blindly according to the Sydney system.

  1.2 Research method

  While fasting on the day and the next day after ESD, the patient began to receive intravenous injection of PPI (omeprazole) to treat ulcers caused by ESD. Starting from day 3, the patients were randomly divided into two groups: one group was given lansoprazole 30 mg/day, and the other group was given polyprezinc 150 mg/day. Underwent endoscopy at 2 months to assess the ulcer status.

  1.3 Scoring criteria

  The scoring criteria for ulcer healing are shown in Table 1. Score 1: there are protrusions near the base of the ulcer; 2 points: there is no protrusion near the base of the ulcer, but not a plain white ulcer scar; 3 points: the plain white ulcer scar is completely covered by regenerating epithelium; The higher the healing, the better.

  1.4 Statistical analysis

  The results are expressed as mean ± standard deviation or median. The size of the lesion was measured by endoscopy, the difference in clinical results was determined by Chi-square test and Mann-Whitney U test, and the diagnosis consistency between doctors was judged by Kappa coefficient evaluation; p<0.05 was statistically significant.

  2 Results and analysis

  2.1 Test grouping

  163 lesions (126 cases of gastric cancer, 36 cases of gastric cancer, 1 case of ectopic gastric mucosa) patients (121 males, 42 females, average age 70 years) were randomly divided into two groups. There were 77 cases in the lansoprazole group (57 cases of gastric cancer, 20 cases of gastric cancer), 77 cases in the lansoprazole combined with polyprezinc group (61 cases of gastric cancer, 15 cases of gastric cancer, 1 case of ectopic gastric mucosa), 154 lesions were all For the first time by ESD.

  2.2 Polyprezinc improves the quality of ulcer healing

  The ulcer healing score of the lansoprazole combined with polyprezinc group was 3 points, indicating that the ulcers healed well, which was significantly higher than the 2.5 points of the lansoprazole group (p<0.0001). PPI combined with the mucosal protective agent polyprezinc can significantly Improve the quality of ulcer healing.

  2.3 Polyprezinc reduces the incidence of ulcer basal process

  Regarding the protrusion of the ulcer base, the lansoprazole combined with polyprezinc group was significantly better than the lansoprazole group (1.3% (1/77) and 20.7% (16/77), p=0.0001), PPI and mucosal protection The combination of agents can not only improve the quality of ulcer healing, but also significantly reduce the incidence of ulcer base protrusions.

  Table 2 compares 17 patients with ulcer base protrusion and 137 patients without ulcer base protrusion. Among the 17 patients with ulcer base protrusions, 1 (6.9%) took polyprezinc, which is much lower than the proportion of patients without protrusions (76/137, 55.4%) (p = 00001) many.

  Among 77 patients, 17 patients (20.7%) were treated with lansoprazole and had ulcer basal protrusions. However, only 1 patient (1.3%) of 77 patients treated with lansoprazole plus polyprezine developed ulcers, indicating that PPI combined with poly Prezinc is very effective in treating ESD-induced ulcers.

  17 patients with ulcer base protrusion stopped taking anti-ulcer drugs. Two months after ESD, biopsy of two patients found severe ulcer base protrusion. The pathological diagnosis of biopsy was that granulation tissue covered the mucosa with intestinal metaplasia.

  One of the patients is a 52-year-old male with 2 early gastric cancers of 10 mm in the greater curvature of the antrum. Two months after ESD, a prominent protrusion appeared at the base of the ulcer, which disappeared completely after 23 months.

  Discuss

  The above data fully demonstrates the effectiveness of the mucosal protective agent polyprezinc combined with PPI in the treatment of endoscopic ulcers. The combination of polyprezinc can improve the quality of ulcer healing, and can also reduce the incidence of ulcer base protrusions and greatly shorten The time for the ulcer to heal is reduced and the patient's worry is reduced. Relaisen (Polyprezinc Granules) is a new mucosal protective agent that can shorten the healing time of ulcers and ensure the quality of ulcer healing. It is a "good partner" for patients after endoscopic treatment.

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Jilin Province Great Great Pharmaceutical Co. LTD
Jilin Province Great Great Pharmaceutical Co. LTD
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Jilin Province Great Great Pharmaceutical Co. LTD

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