目的观察雷贝拉唑联合铋剂对三联药物治疗失败的幽门螺杆菌阳性的消化性溃疡患者的临床疗效。方法选取36例已应用铋剂三联疗法治疗失败的幽门螺杆菌阳性的消化性溃疡患者作为研究对象,对其应用雷贝拉唑、铋剂联合两种抗生素治疗。治疗4周后观察患者的临床疗效。结果 36例患者均完成本次治疗,治疗4周后复查幽门螺杆菌,阴性33例,幽门螺杆菌根除率为91.67%;镜下复查消化性溃疡,治愈18例,显效9例,有效7例,无效2例,总有效率为94.44%。出现头痛4例,恶心5例,腹泻2例,舌苔及大便呈灰黑色18例,以上不良反应均轻微,疗程结束停药后逐渐消失,未发生药物过敏、休克等严重不良反应,未有因不良反应而停药终止治疗者。结论雷贝拉唑、铋剂联合抗生素治疗幽门螺杆菌阳性的消化性溃疡临床疗效好,患者药物耐受性好,且药物不良反应轻微。 Objective To observe the clinical efficacy of rabeprazole combined with bismuth in the treatment of peptic ulcer patients with Helicobacter pylori-positive triple-drug failure. Methods Thirty - six patients with H. pylori - positive peptic ulcer who had failed bismuth triple therapy were enrolled in this study. Rabeprazole and bismuth were combined with two antibiotics. After 4 weeks of treatment, the clinical efficacy was observed. Results Thirty-six patients completed this treatment. Helicobacter pylori was reexamined in 4 weeks after treatment, 33 cases were negative, and the eradication rate of Helicobacter pylori was 91.67%. Peptic ulcer was examined microscopically in 18 cases, 9 cases were markedly effective and 7 cases were effective , 2 cases were ineffective, the total effective rate was 94.44%. There were 4 cases of headache, nausea in 5 cases, diarrhea in 2 cases, gray tongue and stool in 18 cases, the above adverse reactions were mild, gradually disappear after the end of treatment without drug allergy, shock and other serious adverse reactions, there is no cause Adverse reactions and discontinued treatment. Conclusions Rabeprazole and bismuth combined with antibiotics in the treatment of H. pylori-positive peptic ulcer clinical efficacy, patients with good drug tolerance, and minor adverse drug reactions.