内镜下注射硬化剂治疗非静脉曲张消化道出血的临床研究(1)
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【摘要】 目的 探讨内镜下注射硬化剂治疗非静脉曲张消化道出血的疗效。方法 按照随机抽样原则,从因呕血和/或黑便在我院消化内科住院并行内镜下止血治疗的患者中,随机抽取160例患者,预先设计随机数字表,根据随机数字表将病例随机分为治疗组(A 组,80例)和对照组(B组,80例),治疗组采用内镜下注射硬化剂(常用1%乙氧硬化醇)止血治疗,对照组采用内镜下注射1:100 000肾上腺素治疗,观察两组患者的首次止血成功率、再出血率、外科手术率、住院天数、死亡率,两组患者均由同一位医师操作完成。结果 内镜下注射硬化剂组首次止血成功率为97%,内镜下注射肾上腺素组首次止血成功率为94%,P>0.05。内镜下注射硬化剂组再出血发生率11%,内镜下注射肾上腺素组再出血发生率27%,P<0.05。两组患者的外科手术率、住院天数和死亡率,差别没有统计学意义。结论 内镜下注射硬化剂治疗非静脉曲张消化道出血的疗效优于内镜下注射肾上腺素。
【关键词】内镜; 硬化剂;肾上腺素; 非静脉曲张消化道出血
Endoscopic sclerosing agent injection for treatment of non-variceal gastrointestinal bleeding
HOU Ying-sheng,LIU Yun-xiang,HUANG Liu-ye.Department of Gastroenterology,Yantai Yu huangding Hospital afficialed to medical college of Qingdao University,Shandong 264000,China
【Abstract】 Objective To evaluate the effect of endoscopic sclerosing agent injection for treatment of non-variceal gastrointestinal bleeding.Methods The 160 patients received endoscopic therapy because ofhematemesis or/and melenawere randomly assigned to 2 groups:endoscopic aethoxysklerolinjection(groupA,n=80)and endoscopic 1:100000 epinephrineinjection(group B,n=80).To inspectinitial hemostasis,rebleeding,surgery,hospital stay,mortality.All the patients were treated by the same endoscopist.Results Initial hemostasis in endoscopic aethoxysklerolinjection group is 97%,initial hemostasis in endoscopic epinephrineinjection group is 94%.(P>0.05).Rebleeding in endoscopic aethoxysklerolinjection group is 11%,rebleeding in endoscopic epinephrine injection group is 27%.(P<0.05).No significant differences were observed between the 2 groups in hospital stay,surgery and mortality.Conclusion Endoscopic aethoxysklerolinjectionis better than endoscopic epinephrineinjection in treating non-variceal gastrointestinal bleeding.
【Key words】
Indoscopic; Sclerosing agent; Epinephrine; Non-variceal gastrointestinal bleeding
消化道出血是临床常见病,近年来,随着内镜治疗技术的不断发展大大减少了急诊手术的比例。内镜治疗方法较多,目前内镜下注射不同药物止血的疗效还缺乏相关研究。本研究探讨内镜下注射硬化剂、内镜下注射肾上腺素对非静脉曲张消化道出血的疗效。
1 资料与方法
1.1 研究对象 自2008年5月至2010年5月,因呕血和/或黑便在我院消化内科住院并行内镜下止血治疗的非静脉曲张消化道出血的患者中,按照随机抽样的原则,随机抽取80例(男女比例1:1.17,年龄17~83)组成内镜下注射硬化剂组(A组),另80例(男女比例为1:1 ......
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