不同Forrest分级溃疡出血患者内镜下注射治疗的疗效观察

Study on injection therapy of Forrest graded peptic ulcer bleeding under endoscopy

目的 探讨不同Forrest分级溃疡出血患者内镜下注射治疗的疗效 ,评估不同Forrest分级溃疡出血患者内镜下注射治疗的必要性。方法 选自 2 0 0 1年 7月至 2 0 0 2年 8月因呕血和 (或 )黑便入院 ,经紧急内镜检查确诊为溃疡性出血患者 81例 ,溃疡出血按Forrest镜下表现分级 ,内镜注射止血治疗组 4 1例 ,内科治疗组 4 0例。结果 内镜组 4 1例 ,止血成功率 95 1% ,对照组 4 0例 ,止血成功率 80 0 % ,两组差异有显著性意义 (P <0 0 5 )。其中ForrestⅠ级、Ⅱa级内镜组止血成功率 (8/ 9、5 / 6 )均高于对照组(3/ 7、3/ 5 ) ,Ⅱb级、Ⅱc级与Ⅲ级两组无明显差异。结论 内镜注射止血治疗简单有效 ,优于单纯药物治疗 ,镜下表现为ForrestI级和Ⅱa级的溃疡出血患者 。

Objective To study the therapeutic effect of e ndoscopic injection on Forrest graded peptic ulcer bleeding and evaluate its sig nificance.Methods From July 2001 to August 2002, eighty-one patients wi th haematemesis and/or hematochezia diagnosed as peptic ulcer by immediate endos copy were divided into two groups based on Forrest grading, 41 were treated with injection therapy (injection group); other 40 with conservative therapy only (c ontrol group).Results The haemostatic rates in injection therapy group and co ntrol group were 95 1% and 80 0% respectively with prominent statistical diffe rence (P<0 05) and between Forrest grade I and Ⅱa also with prominent stat istical difference , but no statistical difference between Forrest grade Ⅱb、Ⅱ c and Ⅲ. Conclusion Endoscopic injection therapy is an effective measure for bleeding peptic ulcer with Forrest grade I and Ⅱa, and is highly superior to the conservative therapy.