急诊胃镜下药物喷洒与药物注射治疗非静脉曲张性上消化道出血的疗效

Efficacy of emergency endoscopic drug spraying vs injection in treatment of nonvariceal upper gastrointestinal bleeding

目的:观察急诊胃镜下药物喷洒与药物注射两种不同方法在急性非静脉曲张性上消化道出血(acute non-variceal upper gastro intestinal bleeding,ANVUGIB)中的作用以及临床疗效.方法:2010-01/2013-01华中科技大学附属武汉市普爱医院西院区收治入院的ANVUGIB患者200例进行分组研究,予以不同的治疗方式,其中观察组100例,采取急诊胃镜下病灶处肾上腺素注射治疗;对照组100例,采用急诊胃镜下病灶处去甲肾上腺素喷洒治疗.观察两组药物的临床止血作用,并详细记录止血的时间以及不良反应等观察指标.结果:观察组止血总有效率为88.0%,显著高于对照组的78.0%(P<0.05).此外,观察组治疗期间不良反应比例为9.0%,亦低于对照组的32.0%(P<0.05).与治疗前相比,两组患者血红蛋白水平均有一定程度的上升,其中以观察组上升更为显著,差异有统计学意义(P<0.05).结论:急诊胃镜下注射肾上腺素治疗ANVUGI-B疗效确切,止血效果好,不良反应少,值得临床推广.

AIM： To compare the clinical efficacy of emer- gency endoscopic drug spraying versus injection in the treatment of acute non-variceal upper gas- trointestinal bleeding （ANVUGIB）. METHODS： Clinical data for ANVUGIB patients treated at our hospital from January 2010 to Jan- uary 2013 were retrospectively analyzed. These patients were randomly and equally divided into two groups： a control group and an obser~ vation group. The observation group underwent emergency endoscopic injection of adrenalin,while the control group underwent emergency endoscopic spraying of adrenalin. The hemostat- ic effect and side effects were compared between the two groups. RESU LTS： The total hemostasis rate was signifi- cantly higher in the observation group than in the control group （88.0% vs 78.0%, P 〈 0.05）. The rate of adverse reactions was significantly lower in the observation group than in the control group （9.0% vs 32.0%, P 〈 0.05）. Compared with pre-treatment values, hemoglobin levels rose in both groups, and the rise was more significant in the observation group （P 〈 0.05）. CONCLUSION＂ Emergency endoscopic injection of adrenalin is associated with a better hemostat- ic effect and fewer side effects in the treatment of ANVUGIB.