经内窥镜治疗急性非静脉曲张性上消化道出血78例临床观察

The clinical study of endoscopic treatment for 78 cases with acute non-variceal upper gastrointestinal hemorrhage

目的探讨经内窥镜治疗急性非静脉曲张性上消化道出血（ANVUGIB）的临床疗效。方法78例ANVUGIB患者（观察组）在内窥镜下根据出血不同采用局部药物喷洒、局部药物注射、钛夹止血等治疗，并与单纯使用奥美拉唑治疗的50例患者（对照组）进行对比分析，采用Forrest分类法评价出血分级。结果观察组治疗后，均在24—72h内止血成功，止血成功率为100．0％，其中采用喷洒药物进行止血治疗27例、注射止血法止血21例、钛夹止血30例；所有患者均获随访，术后2个月复发2例（2．6％），经二次内窥镜下止血成功。临床治疗效果：观察组总有效率100．0％、平均输血量0ml，对照组分别为82．0％、（312±69）ml，两组总有效率、平均输血量差异均有统计学意义（X2=15．101，P=0．0001；t=23．964，P=0．000）。结论经内窥镜治疗ANVUGIB疗效肯定、安全、创伤小，可作为治疗ANVUGIB的首选治疗方法。

Objective To study the clinical effect of endoscopic treatment for acute non-variceal upper gastrointestinal bIeeding. Methods The clinical data of 78 cases in our hospital with acute non-variceal upper gastrointestinal bleeding were retrospectively analyze. All patients were checked by gastroscopy accompanied by endoscopic treatment. Another 50 cases received ogilvy pull thiazole treatment were analyzed. Results After endoscopic therapy, all patients were successfully achieved hemostasis, success rate 100.0%. Of which 27 cases were treated by spraying drugs in conducting hemostasis ,25 cases succeeded at the first time, the other two turned to injection after the failure; 21 cases were treated by injection to stanch bleeding succeeded for the first time;30 cases were treated with titanium clips made it at the first course. None of the patients transferred to surgical treatment, no complications such as perforation and no death. Curative effect of Imidazole group compared with ogilvy pull is different with, a statistical significance（P 〈 0.05 ）. Conclusion Endoscopic treatment for acute non-variceal upper gastrointestinal bleeding could be affirmed, and relatively safe,little trauma, and it could be used as the first method in treating non-variceal upper gastrointestinal bleeding.