内镜下注射和喷洒注射用蛇毒血凝酶治疗上消化道出血98例临床分析

目的探讨内镜下注射和喷洒注射用蛇毒血凝酶治疗上消化道出血的效果。方法选取2009年1月～2010年1月收治的98例非食管胃底静脉破裂出血的上消化道出血患者,将其完全随机分为观察组和对照组各49例。对照组患者采用内镜直视下注射和喷洒凝血酶的方法进行止血治疗,观察组患者采用内镜下注射和喷洒注射用蛇毒血凝酶治疗,比较两组患者治疗后至出血停止时间、出血量、2周内再次出血比率。综合评价内镜下注射和喷洒注射用蛇毒血凝酶治疗非食管胃底静脉破裂出血的上消化道出血患者的疗效。结果两组患者经治疗后,观察组止血时间短,出血量少,差异有统计学意义(P<0.05);两组患者治疗后2周内再次发生出血的比率,观察组较对照组明显低(P<0.05)。结论内镜下注射和喷洒注射用蛇毒血凝酶对非食管胃底静脉出血的其他上消化道出血患者进行治疗,具有止血速度快、复发率低的优点,值得临床推广应用。

Objective To evaluate the effect of endoscopic injection and spray treatment of upper gastrointestinal bleeding reptilase.Methods Ninety-eight patients with upper gastrointestinal bleeding and non-esophageal and gastric variceal bleeding from January 2009 to January 2010 treated in our hospital were chosen as the object.All patients were randomly divided into the observation group and the control group.The control group were treated with endoscopic injection and spray methods of hemostasis thrombin.The observation group were treated with endoscopic injection and spray reptilase treatment.The bleeding time to stop,blood loss,the ratio of re-bleeding in 2 weeks after treatment for the two groups were compared.Evaluate comprehensively the effect of endoscopic injection and spray reptilase treatment of non-esophageal and gastric variceal bleeding in patients with upper gastrointestinal bleeding.Results The bleeding time to stop after treatment and blood loss were compared,the observation group had obvious advantages（P0.05）.The recurrence rate of bleeding within 2 weeks after treatment for the two groups were compared,the observation group was significantly lower than the control group （P0.05）.Conclusion Endoscopic injection and spraying reptilase for non-esophageal and gastric variceal bleeding in patients with other upper gastrointestinal bleeding has the advantage of fast bleeding and low recurrence rate,and it is worthy of clinical application.