内镜下金属钛夹联合注射肾上腺素治疗消化性溃疡出血的疗效分析

Analysis of endoscopic treatment for peptic ulcer bleeding with Adrenaline injection and titanium clip

目的探讨内镜下金属钛夹联合注射肾上腺素治疗消化性溃疡出血的临床疗效,评价治疗的有效性及安全性。方法将2012年3月-2014年3月该院经急诊胃镜检查确诊为消化性溃疡出血(内镜下Forrest分级为Ia、Ib、IIa和IIb)的158例患者,随机分为实验组和对照组,每组各79例,实验组采用金属钛夹联合注射肾上腺素治疗,对照组采用单纯注射肾上腺素治疗,比较两组治疗效果及并发症。结果两组即时止血率均为100.00%,实验组再出血率为1.27%(1/79),对照组为6.33%(5/79),两组比较差异有统计学意义(P<0.05),外科手术率实验组为0.00%,对照组为2.54%(2/79),两组比较差异有统计学意义(P<0.05)。全部病例均未出现穿孔及其他术后并发症。结论内镜下金属钛夹联合注射肾上腺素治疗消化性溃疡出血是一种疗效高、创伤低、并发症少的治疗方法,具有一定的临床价值。

【Objective】To explore the effect of acute gastrointestinal bleeding treated with Adrenaline injection and titanium clip.【Methods】Retrospective analysis was made of clinical data of 158 patients who were treated with endoscopic because of acute upper gastrointestinal bleeding from March 2012 to March 2014. They were randomly divided into experimental group and control group, each group had 79 cases. Experimental group was treated with Adrenaline injection treatment, the control group was treated with Adrenaline injection and titanium clip. Treatment effects and complications were compared between the two groups. 【Results】The immediate hemostasis rate of two groups was 100.00%, the rate of rebleeding was 1.27%（1/79） in the experimental group, the control group was6.33%（5/79）, significant difference between the two groups（P〈0.05）, surgical operation rate was 0.00% in the experimental group, the control group was 2.54%（2/79）, the difference between the two groups was significant（P〈0.05）. Perforation and other complications were not found in all cases. 【Conclusion】Titanium clips combined Adrenaline injection of epinephrine in the treatment of bleeding peptic ulcer is a kind of high efficacy, low trauma,less complication method with essential clinical value.