消化内镜下治疗急性非静脉曲张上消化道出血的临床效果观察

Observation of Clinical Effect of Digestive Endoscopy in Treatment of Acute Non Variceal Upper Gastrointestinal Bleeding

目的探讨消化内镜下治疗急性非静脉曲张上消化道出血的临床治疗效果。方法选取我院2019年2月至2020年9月收治的124例急性非静脉曲张上消化道出血患者作为研究对象,按照患者的止血治疗方式将患者分成三组,其中36例患者在内镜下局部注射药物止血治疗,作为A组;55例患者内镜下药物喷洒止血治疗;作为B组,33例患者内镜下金属钛夹钳夹止血,作为C组。比较不同治疗方案首次止血成功率、总有效率、再出血率;同时比较不同治疗方案下患者的症状缓解时间、治疗结局。结果 A组首次止血成功率、总有效率、再出血率分别为86.11%、94.44%、25.00%;B组首次止血成功率、总有效率、再出血率分别为94.55%、98.18%、9.09%;C组首次止血成功率、总有效率、再出血率分别为96.97%、100.00%、6.06%,其中C组表现最佳。B组、C组呕血消失时间、潜血试验转阴时间、引流变清时间、住院时间均短于A组,差异有统计学意义(P<0.05)。A组转外科手术率11.11%,死亡率0.00%;B组转外科手术率3.64%,死亡率0.00%;C组转外科手术率0.00%,死亡率0.00%。结论内镜下金属钛夹钳夹止血的表现最好,首次止血成功率高,再出血率,且患者的恢复速度较快,安全性高,值得应用推广。

Objective To probe into the clinical effect of digestive endoscopy in treatment of acute non variceal upper gastrointestinal bleeding.Methods 124 cases of patients with acute non variceal upper gastrointestinal bleeding and who treated in our hospital from February 2019 to September 2020 were selected as the research objects,and the patients were divided into three groups according to the hemostatic treatment.36 cases of patients were treated with local injection of drugs under endoscopy as the group A;55 cases of patients were treated with endoscopic drug spraying for hemostasis as the group B,and 33 cases of patients were treated with metal titanium clamp under endoscope as the group C.Then,the first hemostasis success rate,total effective rate and rebleeding rate of different treatment schemes were compared,and the symptom relief time and treatment outcome of patients under different treatment schemes were compared.Results In group A,the success rate of first hemostasis,total effective rate and rebleeding rate were 86.11%,94.44% and 25.00% respectively;In group B,the success rate of first hemostasis,total effective rate and rebleeding rate were 94.55%,98.18% and 9.09% respectively;In group C,the success rate of first hemostasis,total effective rate and rebleeding rate were 96.97%,100.00% and 6.06%,respectively,and the group C was the best.The hematemesis disappearance time,occult blood test negative time,drainage clearance time and hospitalization time in group B and group C were shorter than those in group A,and the difference was statistically significant (P<0.05).In group A,the conversion rate to surgery was 11.11%,and the mortality rate was 0.00%;In group B,the rate of conversion to surgery was 3.64%,and the mortality was 0.00%;In group C,the conversion rate to surgery was 0.00%,and the mortality rate was 0.00%.Conclusion The endoscopic metal titanium clamp hemostasis performance is the best,the first hemostasis success rate is high,rebleeding rate,and the patient’s recovery speed is fast,high safety,thus it is worth applying and promoting.