无痛胃镜下注射盐酸肾上腺素治疗急性非静脉曲张上消化出血的效果

Effects of adrenaline hydrochloride in painless gastroscopy on acute non-varices upper gastrointestinal bleeding

目的探讨无痛胃镜下药物不同使用方式治疗急性非静脉曲张上消化出血的临床效果。方法选择2019年3月至2020年1月于河北省唐山市协和医院就诊的92例急性非静脉曲张上消化道出血患者,采用随机数字表法将其分为喷洒组和注射组,每组46例。喷洒组采取胃镜下喷洒血凝酶进行治疗,注射组采取胃镜下注射盐酸肾上腺素进行治疗。比较两组临床疗效、出血停止时间、5 min内出血停止率、1周内再出血率、血清脂多糖(LPS)含量、血清C反应蛋白(CRP)含量及不良反应发生情况。结果注射组疗效优于喷洒组,差异有统计学意义(P<0.05)。注射组出血停止时间短于喷洒组,差异有统计学意义(P<0.05)。注射组5 min内出血停止率高于喷洒组,差异有统计学意义(P<0.05)。注射组1周内再出血率低于喷洒组,差异有统计学意义(P<0.05)。治疗后两组血清LPS、CRP含量低于治疗前,且注射组低于喷洒组,差异有统计学意义(P<0.05)。注射组不良反应总发生率低于喷洒组,差异有统计学意义(P<0.05)。结论无痛胃镜下采取注射盐酸肾上腺素相较于喷洒血凝酶治疗急性非静脉曲张上消化道出血患者,止血效果更好,有助于降低血清LPS含量和炎症因子含量,安全性高。

Objective To explore the clinical effect of different use of drugs under painless gastroscope in the treatment of acute non-variceal upper gastrointestinal bleeding.Methods A total of 92 patients with acute non-variceal upper gastrointestinal bleeding who were treated in Union Hospital of Tangshan City,Hebei Province from March 2019 to January 2020 were selected and randomly divided into groups,with 46 cases in each group.The spray group was treated with hemocoagulase under gastroscope,while the injection group was treated with adrenaline hydrochloride under gastroscope.The clinical efficacy,bleeding stop time,bleeding stop rate within five minutes,rebleeding rate within a week,serum lipopolysaccharide(LPS)content,serum C-reactive protein(CRP)content,and occurrence of adverse reactions were compared between the two groups.Results The efficacy of the injection group was significantly better than that of the spray group,and the difference was statistically significant(P<0.05).The bleeding stop time in the injection group was shorter than that in the spray group,and the difference was statistically significant(P<0.05).The bleeding stop rate within five minutes in the injection group was higher than that in the spray group,and the difference was statistically significant(P<0.05).The rebleeding rate within a week in the injection group was lower than that in the spray group,and the difference was statistically significant(P<0.05).After treatment,the levels of serum LPS and CRP in the two groups were lower than those before treatment,while the serum levels of the injection group were lower than those of the spray group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the injection group was lower than that in the spray group,and the difference was statistically significant(P<0.05).Conclusion The injection of adrenaline hydrochloride under painless gastroscopy has a better hemostatic effect than spraying hemocoagulase in the treatment of patients with acute non-varices upper gastrointestinal bleeding.It helps to reduce serum endotoxin and inflammatory factor content,thereby improving treatment safety.