内镜止血在急性非静脉曲张性上消化道出血治疗中的临床价值分析

Analysis of the clinical value of endoscopic hemostasis in the treatment of acute non-varices upper gastrointestinal hemorrhage

目的分析内镜止血在急性非静脉曲张性上消化道出血治疗中的临床价值。方法84例急性非静脉曲张性上消化道出血患者,依据随机数字表法分为对照组和观察组,每组42例。对照组患者给予保守药物治疗,观察组患者给予保守药物联合内镜止血治疗。比较两组出血持续时间、肠鸣恢复音时间、住院时间,治疗前后血红蛋白、血氧饱和度、动脉血氧分压(PaO2)水平、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,疗效、再出血发生情况。结果观察组出血持续时间、肠鸣音恢复时间、住院时间分别为(6.21±1.24)h、(16.78±1.84)h、(4.11±1.21)d,均短于对照组的(9.25±2.94)h、(26.12±1.81)h、(6.78±1.27)d,差异有统计学意义(P<0.05)。治疗后,两组血红蛋白、血氧饱和度、PaO2、APACHEⅡ评分均较治疗前改善,且观察组血红蛋白(114.51±13.21)g/L、血氧饱和度(96.56±2.01)%、PaO2(84.64±7.52)mm Hg(1 mm Hg=0.133 kPa)均显著高于对照组的(102.12±5.21)g/L、(95.56±2.21)%、(76.64±6.78)mm Hg,APACHEⅡ评分(8.56±1.01)分显著低于对照组的(10.56±1.23)分,差异有统计学意义(P<0.05)。观察组治疗总有效率100.00%高于对照组的80.95%,差异有统计学意义(P<0.05)。观察组再出血发生率0低于对照组的19.05%(8/42),差异有统计学意义(P<0.05)。结论保守药物联合内镜止血治疗急性非静脉曲张性上消化道出血的临床效果确切,可加速止血,降低再出血发生率,并维持生命体征稳定,加速患者病情的恢复,缩短住院的时间。

Objective To analyze the clinical value of endoscopic hemostasis in the treatment of acute non-varices upper gastrointestinal hemorrhage.Methods A total of 84 patients with acute non-varices upper gastrointestinal hemorrhage were divided into control group and observation group according to random numerical table,with 42 cases in each group.Patients in the control group were treated with conservative drugs,and patients in the observation group were treated with conservative drugs combined with endoscopic hemostasis.The duration of hemorrhage,recovery time of bowel sounds,hospitalization time,hemoglobin,blood oxygen saturation,arterial partial pressure of oxygen(PaO2)before and after treatment,acute physiological and chronic health evaluationⅡ(APACHEⅡ)score,efficacy and re-hemorrhage status of the two groups were compared.Results The duration of hemorrhage,recovery time of bowel sounds and hospitalization time of the observation group were(6.21±1.24)h,(16.78±1.84)h and(4.11±1.21)d,which were all shorter than(9.25±2.94)h,(26.12±1.81)h and(6.78±1.27)d of the control group,and the difference was statistically significant(P<0.05).After treatment,the hemoglobin,blood oxygen saturation,PaO2,and APACHEⅡscore of the two groups were improved compared with those before treatment.The hemoglobin(114.51±13.21)g/L,blood oxygen saturation(96.56±2.01)%,PaO2(84.64±7.52)mm Hg(1 mm Hg=0.133 kPa)of the observation group were significantly higher than(102.12±5.21)g/L,(95.56±2.21)%,(76.64±6.78)mm Hg of the control group,and APACHEⅡscore(8.56±1.01)points was significantly lower than(10.56±1.23)points of the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment 100.00%of the observation group was higher than 80.95%of the control group,and the difference was statistically significant(P<0.05).The re-hemorrhage rate 0 of the observation group was lower than 19.05%(8/42)of the control group,and the difference was statistically significant(P<0.05).Conclusion Conservative drugs combined with endoscopic hemostasis have a definite clinical effect in the treatment of acute non-varices upper gastrointestinal hemorrhage,which can accelerate hemostasis,reduce the incidence of rebleeding,and maintain the stability of vital signs,accelerate the recovery of the patients,and shorten the hospitalization time.