胃镜下钛夹夹闭联合奥美拉唑治疗老年上消化道出血的临床观察

Effect of titanium clip under gastroscopy combined with omeprazole on elderly patients with upper gastrointestinal hemorrhage

目的探讨老年上消化道出血患者经胃镜下钛夹夹闭联合奥美拉唑治疗的临床效果。方法抽取2018年12月至2019年12月于河南科技大学第二附属医院接受治疗的老年上消化道出血患者132例,采用数字奇偶法将入选者分为观察组(奇数)与对照组(偶数),每组66例。所有患者均接受常规治疗联合奥美拉唑治疗,观察组在此基础上实施胃镜下钛夹夹闭治疗,评价并比较两组患者的临床疗效;观察并记录两组患者治疗期间不良反应发生情况。结果观察组治疗总有效率(95.45%,63/66)高于对照组(83.33%,55/66),差异有统计学意义(P<0.05)。观察组出血量少于对照组,止血时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。两组治疗期间恶心呕吐、腹胀、头晕及嗜睡发生率等不良反应发生率比较差异未见统计学意义(P>0.05);且观察组经胃镜下钛夹夹闭治疗后无明显并发症发生。结论老年上消化道出血患者经胃镜下钛夹夹闭联合奥美拉唑治疗止血效果显著,更利于缩短止血时间、减少出血量,且无明显并发症发生,安全性较高,临床应用价值较高。

Objective To investigate the effects of titanium clip under gastroscopy combined with omeprazole on elderly patients with upper gastrointestinal hemorrhage.Methods A total of 132 elderly patients with upper gastrointestinal hemorrhage who were treated in the Second Affiliated Hospital of Henan University of Science and Technology from December 2018 to December 2019 were selected,and they were divided into observation group(odd number)and control group(even number)by parity of admission number,with 66 cases in each group.All patients received conventional treatment combined with omeprazole.On this basis,patients in the observation group were treated by titanium clip under gastroscopy.The efficacy of the two groups were evaluated and compared,and the incidences of adverse reactions during treatment of the two groups were observed and recorded.Results The total effective rate of the observation group(95.45%,63/66)was higher than that of the control group(83.33%,55/66),and the difference was statistically significant(P<0.05).The bleeding volume of the observation group was less than that of the control group,and the hemostasis time and hospital stay were shorter than those of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of nausea and vomiting,abdominal distension,dizziness and drowsiness between the two groups(P>0.05);and the observation group had no obvious complication after the treatment with titanium clip under gastroscopy.Conclusions Titanium clip under gastroscopy combined with omeprazole has a significant hemostatic effect in the treatment of elderly patients with upper gastrointestinal hemorrhage,which is more conducive to shortening the time of hemostasis,reducing the amount of bleeding,without obvious complications.The treatment protocol has high safety and high clinical application value.