活动出血非静脉曲张性上消化道出血行胃镜下注射肾上腺素联合钛夹治疗效果、止血指标及不良事件分析

Analysis of the Therapeutic Effect,Hemostatic Indexes and Adverse Events of Gastroscopic Injection of Epinephrine Combined with Titanium Clips in Patients with Active Bleeding and Non-variceal Upper Gastrointestinal Bleeding

目的分析活动出血非静脉曲张性上消化道出血行胃镜下注射肾上腺素联合钛夹治疗效果、止血指标及不良事件。方法方便选择2021年2月—2022年2月济南市长清区人民医院收治的活动出血非静脉曲张性上消化道出血患者88例,按随机数表分为两组。对照组44例行胃镜下注射肾上腺素治疗,研究组44例行胃镜下注射肾上腺素联合钛夹治疗,对两组治疗效果、止血指标及不良事件进行比较。结果研究组立即止血率和有效止血率比对照组高,且再出血率低于对照组,差异有统计学意义(χ^(2)=4.062、2.009、4.062,P<0.05);研究组止血时间(26.31±9.86)h与住院时间(7.22±2.09)d比对照组短,差异有统计学意义(t=8.859、10.145,P<0.05);研究组感染、穿孔、发热、周围循环衰竭等不良反应发生率13.63%比对照组38.63%低,差异有统计学意义(χ^(2)=7.122,P<0.05)。结论活动出血非静脉曲张性上消化道出血患者采用胃镜下注射肾上腺素联合钛夹治疗,可帮助患者快速止血,减少术后不良事件,能有效缩短其住院时间,临床上值得推广使用。

Objective To analyze the therapeutic effect,hemostatic indexes and adverse events of active bleeding non-variceal upper gastrointestinal bleeding with epinephrine injection under gastroscope combined with titanium clips.Methods A total of 88 patients with active bleeding and non-variceal upper gastrointestinal bleeding who were admitted to Changqing District People´s Hospital of Jinan City from February 2021 to February 2022 were conveniently selected and divided into two groups according to the random number table.44 cases in the control group were treated with epinephrine injection under gastroscope,and 44 cases in the study group were treated with epinephrine injection under gastroscope combined with titanium clips.The therapeutic effects,hemostatic indexes and adverse events were compared between the two groups.Results The immediate hemostasis rate and effective hemostasis rate in the study group were higher than those in the control group,and the rebleeding rate was lower than that in the control group,and the difference was statistically significant(χ^(2)=4.062,2.009,4.062 P<0.05);the hemostasis time(26.31±9.86)h and hospital stay(7.22±2.09)d in the study group were shorter than those in the control group,and the difference was statistically significant(t=8.859,10.145,P<0.05);the incidence of adverse reactions such as infection,perforation,fever,and peripheral circulatory failure in the study group was 13.63%lower than that in the control group 38.63%,and the difference was statistically significant(χ^(2)=7.122,P<0.05).Conclusion Endoscopic injection of epinephrine combined with titanium clips in patients with active bleeding and non-variceal upper gastrointestinal bleeding can help patients stop bleeding quickly,reduce postoperative adverse events,and effectively shorten their hospital stay.It is worthy of clinical use.