内镜下氩离子凝固术治疗胃十二指肠出血的疗效观察

目的探讨胃十二指肠出血患者应用内镜下氩离子凝固术治疗的效果以及对有效止血和并发症发生率的影响。方法114例胃十二指肠出血患者通过抽签的方式分为对照组和观察组,每组各57例。对照组进行内镜下肾上腺素注射止血治疗,观察组应用内镜下氩离子凝固术治疗。比较两组的临床疗效、有效止血情况、止血时间、并发症发生情况等,以及治疗前后两组的应激反应指标变化。结果观察组治疗总有效率(91.23%)明显高于对照组(77.19%),差异有统计学意义(P=0.040)。观察组初次止血成功率(96.49%)明显高于对照组(85.96%),再出血率(3.51%)明显低于对照组(14.04%),止血时间明显短于对照组,差异均有统计学意义(P均<0.05)。观察组并发症总发生率(7.02%)明显低于对照组(21.05%),差异有统计学意义(P<0.05)。治疗后,观察组应激反应指标去甲肾上腺素(NE)、肾上腺素(E)水平明显低于对照组,差异有统计学意义(P<0.001)。结论内镜下氩离子凝固术治疗胃十二指肠出血的疗效良好且安全性高。

Objective To investigate the effect of endoscopic argon plasma coagulation in the treatment of patients with gastroduodenal hemorrhage and its effect on effective hemostasis and the incidence of complications.Methods 114 patients with gastroduodenal hemorrhage were divided into control group and observation group by drawing lots,with 57 cases in each group.The control group was treated with endoscopic epinephrine injection to stop bleeding,while the observation group was treated with endoscopic argon plasma coagulation.The clinical efficacy of the two groups,effective hemostasis,hemostasis time,complications,and before and after treatment of the two groups of stress response index changes were compared.Results The total effective rate of the observation group(91.23%)was significantly higher than that of the control group(77.19%),and the difference was statistically significant(P=0.040).The success rate of initial hemostasis of the observation group(96.49%)was significantly higher than that of the control group(85.96%),the rate of rebleeding of the observation group(3.51%)was significantly lower than that of the control group(14.04%),and the hemostasis time of the observation group was significantly shorter than that of the control group,with statistical significance(all P<0.05).The total incidence of complications in the observation group(7.02%)was significantly lower than that in the control group,with statistical significance(21.05%)(P<0.05).After treatment,the levels of norepinephrine(NE)and epinephrine(E)in the observation group were significantly lower than those in the control group,with statistical significance(P<0.001).Conclusion Endoscopic argon plasma coagulation is effective and safe in the treatment of gastroduodenal bleeding.