内镜下电凝与钛夹联合注射血凝酶治疗重症消化性溃疡出血的疗效比较

Comparison of treatment effect of severe peptic ulcer bleeding between electrocoagulation and metal titanium clips combined with injection hemocoagulase under endoscopy

目的探讨内镜下电凝与钛夹联合注射血凝酶治疗重症消化性溃疡出血的疗效及安全性。方法 68例重症消化性溃疡出血患者随机分为电凝组与钛夹组各34例,均采取联合内镜下注射血凝酶治疗,比较两组治疗疗效及并发症发生情况。结果电凝组即时止血率97.06%,术后1周之内再出2例,止血成功率94.12%;钛夹组即时止血率100.00%,术后1周之内再出1例,止血成功率97.06%,两组比较差异无显著性(P>0.05)。电凝组1例止血失败转为外科手术治疗,2例患者术后再出血采用内镜下再次注射止血后成功;钛夹组在术后3 d时1例患者出现呕血,内镜检查发现钛夹脱落,再次内镜下钛夹治疗后止血成功,两组患者治疗期间均无穿孔等并发症发生。结论内镜下电凝与钛夹联合注射血凝酶治疗重症消化性溃疡出血均能起到良好止血效果,且并发症少,安全性高。

【Objective】 To investigate the treatment effect of severe peptic ulcer bleeding and security of electrocoagulation and metal titanium clips combined with injection hemocoagulase under endoscopy.【Methods】68patients with severe peptic ulcer hemorrhage were selected, and randomly divided into electrocoagulation group and titanium clip group, with each group had 34 cases. Both of two groups proceeded hemostatic measures combined with endoscopic injection of hemocoagulase, curative effect and complications were compared. 【Results】 Instant hemostasis rate and hemostatic success rate in electrocoagulation group were 97.06% and 94.12%,respectively.Instant hemostasis rate and hemostatic success rate in titanium clip group were 100.00% and 97.06%,respectively.There was no significant difference（P 0.05）. In electrocoagulation group 1 case of hemostatic failed to surgical treatment, 2 cases of patients occurred bleeding again in postoperative and accepted hemostatic measures under endoscopy. 1 case occurred hematemesis 3d after operation because of titanium clip off in titanium clip group,accepted process again. No complications occurred. 【Conclusion】 Electrocoagulation and metal titanium clips combined with injection hemocoagulase under endoscopy showed well treatment effect and security in the treatment of severe peptic ulcer bleeding, and it was of fewer complications and high safety.