胃镜下止血联合药物治疗非静脉曲张性上消化道出血患者的效果

Effects of gastroscopic hemostasis combined with drug therapy in treatment of patients with non-variceal upper gastrointestinal bleeding

目的:观察胃镜下止血联合药物治疗非静脉曲张性上消化道出血(NVUGIB)患者的效果。方法:回顾性分析2018年7月至2020年7月该院收治的62例NVUGIB患者的临床资料,按照治疗方法不同分为对照组和观察组各31例。对照组给予奥美拉唑治疗,观察组在对照组基础上联合进行胃镜下止血治疗,比较两组临床疗效、术中和术后恢复指标水平、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)]水平及不良反应发生率。结果:观察组治疗总有效率为96.77%,高于对照组的77.42%,差异有统计学意义(P<0.05);观察组术中出血量少于对照组,止血时间、肠鸣音恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组CRP、TNF-α、PCT水平均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为6.45%,低于对照组的25.81%,差异有统计学意义(P<0.05)。结论:胃镜下止血联合药物治疗NVUGIB患者,可提高临床疗效,缩短患者预后恢复时间,降低炎性因子水平,且安全性高,其效果优于单纯药物治疗。

Objective: To observe effects of gastroscopic hemostasis combined with drug therapy in treatment of patients with non-variceal upper gastrointestinal bleeding(NVUGIB). Methods: The clinical data of 62 NVUGIB patients admitted to our hospital from July 2018 to July 2020were retrospectively analyzed, and they were divided into control group and observation group according to different treatment methods, 31 cases in each. The control group was given Omeprazole, while the observation group used gastroscopic hemostasis on the basis of that of the control group. The clinical efficacy, the intraoperative and postoperative recovery index levels, the inflammatory factor indexes [C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), procalcitonin(PCT)] levels and the incidence of adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was 96.77%, which was higher than 77.42% of the control group, and the difference was statistically significant(P<0.05). The intraoperative blood loss in the observation group was less than that in the control group;the hemostasis time, the bowel sound recovery time, and the hospitalization time were all shorter than those in the control group;and the differences were statistically significant(P<0.05).After the treatment, the levels of CRP, TNF-α and PCT in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). Further, the incidence of adverse reactions in the observation group was 6.45%, which was lower than 25.81% in the control group, and the difference was statistically significant(P<0.05). Conclusions: Gastroscopic hemostasis combined with drug therapy in the treatment of the patients with NVUGIB can improve clinical efficacy, shorten the prognosis time and the recovery time, and reduce the levels of inflammatory factors. Moreover, it is superior to single drug therapy.