血凝酶与肾上腺素内镜下注射止血治疗的比较

Comparison of the hemostasis with hemocoagulase and epinephrine in Endoscopic injection therapy

目的比较血凝酶与1∶10000肾上腺素在内镜下局部注射的止血作用及其安全性。方法行胃镜检查和治疗发现消化性溃疡Forrest分级Ib、Ⅱ型或胃镜下黏膜活检、息肉摘除引起局部出血不止的患者60例,随机分为血凝酶组和肾上腺素组,每组30例,行内镜下注射治疗,Ib型患者在出血部位及血管周围多点注射,每点0.5～1.0ml,直至出血停止;Ⅱ型患者均多点注射,总量4ml。结果两组注射后即刻止血率均为100%。血凝酶组24小时止血率为96.7%(29/30),肾上腺素组为90.0%(27/30),两组比较无显著性差异。血凝酶组24小时再出血1例(IIa型),肾上腺素组24小时再出血3例(Ib型1例、IIa型2例),均经内镜下联合治疗出血停止。结论血凝酶作为内镜下注射治疗的局部用药安全有效。

Objective To assess the effect and safty of hemocoagulase and epinephrine for hemostasis in Endoscopic injection therapy.Methods 60 patients with peptic ulcer bleeding（Forrest Ib and II）or biopsy bleeding or polypus removal bleeding were randomly divided into 2 groups.30 were injected with hemocoagulase to stop bleeding,other 30 with 1：10000 solution of epinephrine.Results Initial haemostatic rate was 100% in both groups.The haemostatic rate within 24h was 96.7% and 90% in hemocoagulase group and epinephrine group,respectively.There were no significant differences between the two groups.（P〉0.05）.Conclusion Hemocoagulase is safe and effective for Endoscopic injection therapy.