内镜下钛夹联合生长抑素治疗上消化道出血的疗效观察

Observation of the effect of endoscopic titanium clip combined with somatostatin on upper gastrointestinal hemorrhage

目的评价内镜下钛夹联合生长抑素治疗上消化道出血的临床疗效。方法70例上消化道出血患者,根据治疗方案不同分为对照组和观察组,各35例。对照组患者采取内镜下钛夹止血治疗,观察组患者采取内镜下钛夹联合生长抑素治疗。比较两组患者的止血效果、呕血消失时间、再出血率、大便潜血转阴时间、住院时间。结果观察组患者治疗总有效率为97.14%(34/35),治疗后再出血率为2.86%(1/35);对照组患者治疗总有效率为77.14%(27/35),治疗后再出血率为20.00%(7/35);观察组患者治疗总有效率高于对照组,再出血率低于对照组,差异有统计学意义(P<0.05)。观察组患者呕血消失时间为(2.50±0.80)d、大便潜血转阴时间为(2.03±1.10)d、住院时间为(5.90±1.20)d,均短于对照组的(4.20±0.95)、(4.20±1.20)、(11.30±1.50)d,差异有统计学意义(P<0.05)。结论单纯内镜下钛夹止血效果有限,联合生长抑素治疗上消化道出血可以提升止血效果、缩短康复时间,进一步降低了再出血风险,是有效的联合治疗方法。

Objective To evaluate the clinical efficacy of endoscopic titanium clip combined with somatostatin on upper gastrointestinal hemorrhage.Methods A total of 70 patients with upper gastrointestinal hemorrhage were divided into control group and observation group according to different treatment regimens,with 35 cases in each group.The control group was treated with endoscopic titanium clip,and the observation group was treated with endoscopic titanium clip combined with somatostatin.The hemostasis effect,disappearance time of hematemesis,rebleeding rate,occult blood turning negative time and hospitalization time were compared between the two groups.Results The total treatment effective rate and rebleeding rate after treatment of the observation group were 97.14%(34/35)and 2.86%(1/35),which were 77.14%(27/35)and 20.00%(7/35)of the control group.The total treatment effective rate of the observation group was higher than that of the control group,and rebleeding rate was lower than that of the control group,and the difference was statistically significant(P<0.05).The disappearance time of hematemesis(2.50±0.80)d,occult blood turning negative time(2.03±1.10)d and hospitalization time(5.90±1.20)d of the observation group were shorter than(4.20±0.95),(4.20±1.20)and(11.30±1.50)d of the control group,and the difference was statistically significant(P<0.05).Conclusion Titanium clips alone have limited hemostatic effects under endoscopy.Combining with somatostatin in the treatment of upper gastrointestinal hemorrhage can improve the hemostatic effect,shorten the recovery time,and further reduce the risk of rebleeding.