老年人消化性溃疡出血的内镜注射治疗

Endoscopic injection therapy on elderly patients with bleeding peptic ulcers

目的评价老年人消化性溃疡出血内镜注射疗法的疗效。方法78例血管显露和活动性出血溃疡中,老年组和非老年组分别为34例和44例,比较两组内镜注射治疗止血率、再出血率、急诊手术率、输血量、住院时间、费用及其并发症等指标。结果(1)内镜注射治疗后,老年组和非老年组的止血率分别为88·24%和93·72%(P>0·05);再出血率分别为11·76%和6·28%(P>0·05);急诊手术率分别为2·94%和4·55%(P>0·05);死亡率分别为11·76%和2·27%(P>0·05);输血量分别为(6·65±4·46)U和(3·50±3·05)U(P>0·05);住院费用分别为(13·95±1·98)千元和(9·16±1·65)千元(P>0·05);住院时间分别为(17·79±8·00)d和(11·59±5·88)d(P<0·05)。(2)仅7例出现轻度不良反应,老年组和非老年组分别为3例和4例(P>0·05)。结论内镜注射疗法安全有效,适用于伴发重要脏器疾患的老年溃疡出血患者。

Objective To study the effect and complication of endoscopic injection therapy on elderly patients with bleeding peptic ulcers. Methods Among 78 peptic ulcer patients with active bleeding or non-bleeding visible vessels, there were 34 patients in elderly group and 44 patients in non-elderly group respectively. The control of bleeding, the rate of rebleeding, the rate of emergency surgery, the amount of blood transfusion, the hospital stay, cost and its complication were compared between the two groups. Results （1）Bleeding ulcers stopped completely in 88.24% for elderly group and 93.72% for non-elderly group（P〉0.05）;the rate of rebleeding were 2.94% and4.55% （P〉0.05） ; the amount of blood transfusion were （6.65±4.46） and （3.50±3.05 ） （unit, P〉0.05） ; the cost were （13.95±1.98） and （9.16±1.65）（thousand yuan RMB, P〉0.05）；the hospital stay were （17.79±8.00） and （11.59±5.88）（day, P〈0.05）. （2）Only 7 patients had mild side effects in which 3 patients in elderly group and 4 patients in non-elderly group respectively（P〉0.05）. Conclusion Endoscopic injection therapy was safe and effective. It can be used to stop bleeding of peptic ulcers in elderly patients with coexisting diseases.