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治疗效果及血清炎性因子的影响

Effect of endoscopic metal titanium clip combined with injection of epinephrine on the efficacy and serum inflammatory factors in patients with peptic ulcer hemorrhage

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出血患者治疗效果及血清炎性因子的影响。方法选择2017年2月至2018年12月渭南市中心医院消化内科收治的110例消化性溃疡出血患者为研究对象,根据随机数表法将患者分为观察组和对照组各55例,对照组患者予内镜下金属钛夹止血治疗,观察组在对照组基础上联合注射肾上腺素,比较两组患者的止血效果(止血时间、输血量、再出血发生率、并发症发生率等)以及治疗前后的内毒素(LPS)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平。结果观察组患者的止血时间、输血量分别为(16.72±3.68)h、(470.29±82.15)mL,均明显少于对照组的(20.58±5.18)h、(518.46±90.64)mL,差异均有统计学意义(P<0.05);观察组患者的再出血发生率为3.64%,明显低于对照组的12.73%,差异有统计学意义(P<0.05);观察组和对照组的并发症发生率分别为1.82%和5.45%,差异无统计学意义(P>0.05);治疗后,观察组患者的血清LPS、hs-CRP及TNF-α水平分别为(22.35±6.28)μg/L、(6.18±2.22)mg/L、(13.87±4.48)ng/L,明显低于对照组的(31.64±7.62)μg/L、(8.49±2.46)mg/L、(18.79±5.34)ng/L,差异均有统计学意义(P<0.05)。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可以有效抑制炎症反应,提高止血效果,且安全性较好。

Objective To investigate the therapeutic effect of endoscopic metal titanium clip combined with epinephrine injection on patients with peptic ulcer hemorrhage and the effect on serum inflammatory factors.Methods A total of 110 patients with peptic ulcer hemorrhage admitted to the Department of Gastroenterology at Weinan Central Hospital from February 2017 to December 2018 were selected as subjects.According to the random number table method,the patients were divided into observation group and control group,with 55 cases in each group.The control group was treated with endoscopic metal titanium clip hemostasis.The observation group was combined with adrenaline on the basis of the control group.Comparison was performed between the two groups on the hemostasis effect(time-to-hemostasis,blood volume for transfusion,rebleeding rate,incidence of complications)and changes in the levels of endotoxin(LPS),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-alpha(TNF-alpha)levels before and after treatment.Results The time-to-hemostasis and blood volume for transfusion were(16.72±3.68)hours and(470.29±82.15)mL in the observation group,respectively,which were significantly less than corresponding(20.58±5.18)hours and(518.46±90.64)mL in the control group(P<0.05).The incidence of rebleeding was 3.64%in the observation group,which was significantly lower than 12.73%in the control group(P<0.05).The incidence of complications in the observation group and the control group were 1.82%and 5.45%,respectively,and the difference was not statistically significant(P>0.05).After treatment,the serum levels of LPS,hs-CRP and TNF-αwere(22.35±6.28)μg/L,(6.18±2.22)mg/L and(13.87±4.48)ng/L in the observation group,respectively,which were significantly lower than corresponding(31.64±7.62)μg/L,(8.49±2.46)mg/L and(18.79±5.34)ng/L in the control group(P<0.05).Conclusion Endoscopic metal titanium clip hemostasis combined with injection of epinephrine in the treatment of peptic ulcer bleeding can effectively inhibit the inflammatory response,improve hemostasis,and the safety of treatment is better.