内镜下钛夹与药物注射治疗急性非静脉曲张性上消化道出血的效果比较(1)
[摘要]目的 比较急性非静脉曲张性上消化道出血(non-varicose upper gastrointestinal bleeding，NVUGIB)内镜下钛夹与药物注射的治疗效果。方法 回顾性分析2015年1月～2019年3月在清远市中医院接受治疗的100例急性NVUGIB患者的临床资料，按治疗方式的不同将其分为A、B组。其中A组57例，采用内镜下钛夹止血方式，B组43例，采用肾上腺素注射治疗。比较两组止血效果与外科手术情况，输血量、恢复速度，不良反应情况。结果 A组即时止血率、有效止血率高于B组，72 h后再出血率、外科手术率低于B组，输血量少于B组，肠鸣音恢复时间、住院时间短于B组，差异均有统计学意义(P<0.05);两组均未发生严重不良反应。结论 相较于药物注射，急性NVUGIB患者用内镜下钛夹治疗可改善止血效果，减少外科手术与输血量，加快患者恢复速度。
[关键词]内镜下钛夹;肾上腺素;急性非静脉曲张性上消化道出血
[Abstract] Objective To compare the therapeutic effect of endoscopic titanium clip and drug injection in the treatment of acute non-varicose upper gastrointestinal bleeding (NVUGIB). Methods The clinical data of 100 patients with acute NVUGIB treated in Qingyuan Hospital of Traditional Chinese Medicine from January 2015 to March 2019 were retrospectively analyzed. They were divided into group A and group B according to different treatment methods， 57 cases in group A were treated with endoscopic titanium clip hemostasis and 43 cases in group B were treated with epinephrine injection. The hemostatic effect， surgical operation， blood transfusion volume， recovery rate and adverse reactions were compared between group A and group B. Results The immediate hemostasis rate and effective hemostasis rate of group A were higher than those of group B， the rebleeding rate and surgical operation rate after 72 hours were lower than those of group B， the blood transfusion volume was less than that of group B， and the recovery time of bowel sounds and hospitalization days were shorter than those of group B， with statistical differences (P<0.05). There were no serious adverse reactions in group A and group B. Conclusion Compared with drug injection， the application of endoscopic titanium clip in the treatment of acute NVUGIB patients can improve the hemostasis effect， reduce the amount of surgical operation and blood transfusion， and accelerate the recovery rate.
[Key words] Endoscopic titanium clip; Adrenaline; Acute non-variceal upper gastrointestinal hemorrhage
急性非靜脉曲张性上消化道出血(non-varicose upper gastrointestinal bleeding，NVUGIB)指静脉曲张外的原因导致吻合口、食管、胰胆管、胃十二指肠等位置的出血，在上消化道出血中占比高达50%～70%[1]，死亡率高达8.5%～14.5%[2]。现阶段用内镜下钛夹与药物注射治疗急性NVUGIB，已有研究证实该方式的有效性[3-4]，但关于两者单独使用治疗效果的比较研究不多。为比较两者的效果及价值，本研究展开回顾性分析，现报道如下。
1资料与方法
1.1一般资料
回顾性分析2015年1月～2019年3月在清远市中医院接受治疗的100例急性NVUGIB患者的临床资料，按照治疗方式的不同将其分为A、B组。A组57例，男34例，女23例;年龄24～64岁，平均(43.2±8.9)岁;凝血酶原时间(prothrombin time，PT)11.2～12.9 s，平均(12.1±0.7)s;出血原因：吻合口溃疡、消化性溃疡、贲门黏膜撕裂症、胃间质瘤分别5、45、4、3例，FORREST分级[5]Ⅰa～Ⅰb级、Ⅱa～Ⅱb级分别24例、33例。B组43例，男27例，女16例，年龄23～65岁，平均(43.8±8.6)岁;PT 11.3～12.8 s，平均(12.2±0.6)s;出血原因：吻合口溃疡、消化性溃疡、贲门黏膜撕裂症、胃间质瘤分别4、33、3、3例;FORREST分级Ⅰa～Ⅰb级、Ⅱa～Ⅱb级分别17例、26例。两组的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。本研究经清远市中医院医学伦理委员会的批准。, http://www.100md.com(汪雪琦 林杏娣 植冠光)
[关键词]内镜下钛夹;肾上腺素;急性非静脉曲张性上消化道出血
[Abstract] Objective To compare the therapeutic effect of endoscopic titanium clip and drug injection in the treatment of acute non-varicose upper gastrointestinal bleeding (NVUGIB). Methods The clinical data of 100 patients with acute NVUGIB treated in Qingyuan Hospital of Traditional Chinese Medicine from January 2015 to March 2019 were retrospectively analyzed. They were divided into group A and group B according to different treatment methods， 57 cases in group A were treated with endoscopic titanium clip hemostasis and 43 cases in group B were treated with epinephrine injection. The hemostatic effect， surgical operation， blood transfusion volume， recovery rate and adverse reactions were compared between group A and group B. Results The immediate hemostasis rate and effective hemostasis rate of group A were higher than those of group B， the rebleeding rate and surgical operation rate after 72 hours were lower than those of group B， the blood transfusion volume was less than that of group B， and the recovery time of bowel sounds and hospitalization days were shorter than those of group B， with statistical differences (P<0.05). There were no serious adverse reactions in group A and group B. Conclusion Compared with drug injection， the application of endoscopic titanium clip in the treatment of acute NVUGIB patients can improve the hemostasis effect， reduce the amount of surgical operation and blood transfusion， and accelerate the recovery rate.
[Key words] Endoscopic titanium clip; Adrenaline; Acute non-variceal upper gastrointestinal hemorrhage
急性非靜脉曲张性上消化道出血(non-varicose upper gastrointestinal bleeding，NVUGIB)指静脉曲张外的原因导致吻合口、食管、胰胆管、胃十二指肠等位置的出血，在上消化道出血中占比高达50%～70%[1]，死亡率高达8.5%～14.5%[2]。现阶段用内镜下钛夹与药物注射治疗急性NVUGIB，已有研究证实该方式的有效性[3-4]，但关于两者单独使用治疗效果的比较研究不多。为比较两者的效果及价值，本研究展开回顾性分析，现报道如下。
1资料与方法
1.1一般资料
回顾性分析2015年1月～2019年3月在清远市中医院接受治疗的100例急性NVUGIB患者的临床资料，按照治疗方式的不同将其分为A、B组。A组57例，男34例，女23例;年龄24～64岁，平均(43.2±8.9)岁;凝血酶原时间(prothrombin time，PT)11.2～12.9 s，平均(12.1±0.7)s;出血原因：吻合口溃疡、消化性溃疡、贲门黏膜撕裂症、胃间质瘤分别5、45、4、3例，FORREST分级[5]Ⅰa～Ⅰb级、Ⅱa～Ⅱb级分别24例、33例。B组43例，男27例，女16例，年龄23～65岁，平均(43.8±8.6)岁;PT 11.3～12.8 s，平均(12.2±0.6)s;出血原因：吻合口溃疡、消化性溃疡、贲门黏膜撕裂症、胃间质瘤分别4、33、3、3例;FORREST分级Ⅰa～Ⅰb级、Ⅱa～Ⅱb级分别17例、26例。两组的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。本研究经清远市中医院医学伦理委员会的批准。, http://www.100md.com(汪雪琦 林杏娣 植冠光)
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