经内镜钛夹治疗急性上消化道出血的临床效果

Clinical effect of endoscopic titanium clip in the treatment of acute upper gastrointestinal hemorrhage

目的探讨经内镜钛夹治疗急性上消化道出血(AUGH)的临床效果。方法选择2018年4月至2019年7月于我院就诊的92例AUGH患者,根据治疗方式的不同将患者分为试验组(n=46,内镜下钛夹止血)与对照组(n=46,内镜下药物注射止血)。比较两组的止血效果、血清炎症因子、应激指标、出血症状评分、Blatchford评分、凝血功能指标及恢复效果。结果试验组的止血总有效率高于对照组(P<0.05)。治疗后,两组的血清CRP、IL-6、TNF-α、Cor、NE水平均降低,且试验组低于对照组(P<0.05)。治疗后,两组的出血症状评分、Blatchford评分均降低,且试验组低于对照组(P<0.05)。治疗后,两组的PT、APTT均缩短,FIB水平均升高,D-D水平均降低,且试验组优于对照组(P<0.05)。试验组的呕血消失时间、OB转阴时间、引流变清时间、肠蠕动恢复时间及住院时间均短于对照组(P<0.05)。结论经内镜钛夹治疗AUGH的止血效果显著,可降低血清炎症因子、应激指标,改善患者的凝血功能,促进临床症状改善。

Objective To investigate the clinical effect of endoscopic titanium clip in the treatment of acute upper gastrointestinal hemorrhage(AUGH).Methods A total of 92 patients with AUGH admitted in our hospital from April 2018 to July 2019 were selected and divided into experimental group(n=46,hemostasis by endoscopic titanium clip)and control group(n=46,hemostasis by endoscopic drug injection)according to different treatment methods.The hemostatic effect,serum inflammatory factors,stress indicators,bleeding symptom score,Blatchford score,coagulation function index and recovery effect were compared between the two groups.Results The total effective rate of hemostasis in the experimental group was higher than that in the control group(P<0.05).After treatment,the levels of serum CRP,IL-6,TNF-α,Cor,NE in the two groups decreased,and those in the experimental group were lower than the control group(P<0.05).After treatment,the bleeding symptom score and Blatchford score in the two groups decreased,and those in the experimental group were lower than the control group(P<0.05).After treatment,PT and APTT in the two groups shortened,FIB level increased,D-D level decreased,and those in the experimental group were better than the control group(P<0.05).The hematemesis disappearance time,OB negative time,drainage clearance time,intestinal peristalsis recovery time and hospitalization time in the experimental group were shorter than those in the control group(P<0.05).Conclusion The endoscopic titanium clip in the treatment of AUGH has significant hemostatic effect,which can reduce the serum inflammatory factors and stress indicators,improve the coagulation function of patients,and promote the improvement of clinical symptoms.