内镜下金属钛夹联合肾上腺素注射治疗Dieulafoy病的疗效观察

Curative observation of the treatment with metal titanic clip combined with epinephrine injection on Dieulafoy's disease under endoscope

目的探讨内镜下金属钛夹联合肾上腺素注射治疗Dieulafoy病的临床疗效。方法收集2007年1月1日-2016年3月31日南京医科大学附属常州第二人民医院内镜下确诊42例Dieulafoy病患者的临床资料进行回顾性分析。根据治疗方案不同,分为观察组和对照组,观察组为内镜下金属钛夹联合肾上腺素注射治疗,对照组为内镜下氩离子血浆凝固术联合肾上腺素注射治疗。比较两组首次止血成功率、再发出血率、转手术率之间的差异。结果观察组与对照组在首次止血成功率及转手术率方面比较,差异无统计学意义(P>0.05);在再发出血率方面比较差异有统计学意义(P<0.05)。结论内镜下金属钛夹联合肾上腺素注射治疗Dieulafoy病可明显降低再发出血率,可作为内镜下治疗止血的首选方案。

Objective To explore the clinical curative effect of the treatment with metal titanic clip combined with epinephrine injection therapy of Dieulafoy＇ s disease. Methods A retrospective analysis was made to the clinical data of 42 cases with confirmed diagnosis of Dieulafoy＇ s disease by endoscope from Jan. 1st, 2007 to Mar. 31st, 2016 in Changzhou No. 2 People＇ s Hospital Affilated to Nanjing Medical University ; they were divided into 2 groups ： the obser- vation group and the control group, hemostatic treatment with mental titanic clip combined with epinephrine injection was performed to cases in the observation group under endoscope while argon plasma coagulation and epinephrine injec- tion was performed to cases in the control group under endoscope. Hemostatic success rate for the first time, reoccur- rence rate of bleeding and the rates of surgery between two groups were compared. Results There were no significant differences in the hemotatic success rate for the first time and the rate of surgery between two groups （P 〉 0.05） ; but there was significant difference in the reoccurrence rate of bleeding （P 〈 0.05）. Conclusion Endoscopic metal titanic clip joint epinephrine injection in the treatment of Dieulafoy＇ s disease can obviously decrease reoccurrences of bleeding, it can be the first choice for hemostatic treatment under endoscope.