内镜下金属钛夹止血与内镜下注射止血药物治疗ANVUGIB的效果及对再出血率的影响

Effect of Hemostasis with Titanium Clip by Endoscope and Hemostatic Drugs by Injection of Endoscope in Patients with ANVUGIB and Its Influence on Rebleeding Rate

目的:探究及比较内镜下金属钛夹止血与内镜下注射止血药物治疗急性非静脉曲张性上消化道出血(ANVUGIB)的效果及对再出血率的影响。方法:将2019年9月-2022年1月莆田市第一医院的80例ANVUGIB患者根据随机数字表法分为A组和B组,每组40例。A组采用内镜下注射止血药物治疗,B组则采用内镜下金属钛夹止血治疗。比较两组治疗总有效率、止血时间、住院时间、再出血率、治疗前后的Rockall评分、症状体征积分及血清C反应蛋白(CRP)、生长抑素(SS)水平。结果:B组治疗总有效率高于A组,止血时间及住院时间均短于A组,治疗后72 h、1周再出血率均低于A组,差异均有统计学意义(P<0.05)。治疗前,两组Rockall评分、症状体征积分及血清CRP、SS水平比较,差异均无统计学意义(P>0.05);治疗后2、5 d,两组Rockall评分、症状体征积分及血清CRP、SS水平较治疗前均改善,且B组Rockall评分、症状体征积分及血清CRP水平均低于A组,血清SS水平均高于A组,差异均有统计学意义(P<0.05)。结论:内镜下金属钛夹止血治疗ANVUGIB的效果优于内镜下注射止血药物,且可有效控制再出血率,因此内镜下金属钛夹止血在ANVUGIB患者中的应用价值相对更高。

Objective:To investigate and compare the effect of hemostasis with titanium clip by endoscope and hemostatic drugs by injection of endoscope in patients with acute non varicose upper gastrointestinal bleeding (ANVUGIB) and its influence on rebleeding rate.Method:A total of 80 patients with ANVUGIB in the Putian Firsh Hospital from September 2019 to January 2022 were divided into group A and group B by the random number table,40 cases in each group.Group A was treated with hemostatic drugs by injection of endoscope,group B was treated with hemostasis with titanium clip by endoscope.Then the total effective rates,hemostasis time,hospitalization time,rebleeding rate,Rockall score,symptom and sign scores,serum CRP and SS levels before and after the treatment of two groups were compared.Result:The total effective rate of group B was higher than that of group A,the hemostasis time and hospitalization time were shorter than those of group A,the rebleeding rate at 72 h and 1 week after treatment were significantly lower than those of group A,the differences were statistically significant (P<0.05).Before treatment,the Rockall score,symptom and sign scores,serum CRP and SS levels of two groups were compared,the differences were not statistically significant (P>0.05);at 2,5 d after treatment the Rockall score,symptom and sign scores,serum CRP and SS levels of two groups were improved compared with those before treatment,and the Rockall score,symptom and sign scores,serum CRP of group B were significantly lower than those of group A,the serum SS levels were significantly higher than those of group A,the differences were all statistically significant (P<0.05).Conclusion:The effect of hemostasis with titanium clip by endoscope in patients with ANVUGIB are significantly better than those of hemostatic drugs by injection of endoscope,and it can effectively control the rebleeding rate,so its application value of hemostasis with titanium clip by endoscope in patients with ANVUGIB is relatively higher.