内镜下金属钛夹联合注射肾上腺素对消化性溃疡出血患者血清炎性因子及治疗效果的影响

Endoscopically guided titanium clip therapy and adrenaline injection for treatment of patients with peptic ulcer bleeding: Clinical efficacy and impact on serum inflammatory cytokines

目的探讨内镜下金属钛夹联合注射肾上腺素对消化性溃疡患者血清炎性因子及治疗效果的影响.方法选择2015-01/2016-12浙江省台州市肿瘤医院收治的消化道出血患者132例为研究对象,采用随机数字表法分为观察组和对照组各66例.对照组给予金属钛夹治疗,观察组给予金属钛夹联合注射肾上腺素治疗,比较两组治疗相关指标、血清炎性因子、不良反应、临床疗效等.结果观察组有效率明显高于对照组(98.48%vs 89.39%,χ~2=4.790,P<0.05);止血时间、治疗出血量、输血量、住院时间明显低于对照组(t=6.842,5.384,6.772,9.407,P<0.05,P<0.01);血清白介素-6(interleukin-6,IL-6)、c-反应蛋白含量明显低于对照组,IL-10含量明显高于对照组(t=7.545,6.071,8.919,P<0.05,P<0.01);穿孔、感染、再出血发生率明显低于对照组(3.03%vs 12.12%,6.06%vs18.18%,1.52%vs 10.61%,χ~2=3.895,4.552,4.790,P<0.05).结论内镜下金属钛夹联合注射肾上腺素有助于提高消化性溃疡出血患者临床疗效,降低不良反应,可能与缓解患者炎症状态等因素有关.

AIM To evaluate the clinical efficacy of endoscopically guided titanium clip therapy and adrenaline injection in the treatment of patients with peptic ulcer bleeding and the impact on serum inflammatory cytokines.METHODS One hundred and thirty-two patients with peptic ulcer bleeding treated from January 2015 to December 2016 were divided into either an observation group or a control group. The control group was given endoscopically guided titanium clip therapy, and the observation group was given endoscopically guided titanium clip therapy and adrenaline injection. Therapeutic indicators, serum inflammatory cytokines, adverse reactions, and clinical efficacy were compared between the two groups.The effective rate was significantly higher in the observation group than in the control group （98.48% vs 89.39%, x^2= 4.790, P 〈 0.05）. Time to achieve hemostasis, blood loss, amount of blood transfusion, and hospital stay were significantly lower in the observation group than in the control group （t = 6.842, 5.384, 6.772, and 9.407, respectively, P 〈 0.05 or 0.01）. Serum levels of interleukin （IL）-6 and C-reaction protein were significantly lower and that of IL-10 was significantly higher in the observation group than in the control group （t = 7.545, 6.071, and 8.919, respectively, P 〈 0.05 or 0.01）. The rates of perforation, infection, and rebleeding were significantly lower in the observation group than in the control group （3.03% vs 12.12%, 6.06% vs 18.18%, and 1.52% vs 10.61%; x^2= 3.895, 4.552, and 4.790, respectively; P 〈 0.05）.CONCLUSION Endoscopically guided titanium clip therapy and adren- aline injection can improve the therapeutic effect in patients with peptic ulcer bleeding and reduce adverse reactions, which may be related to the alleviation of the inflammatory state.