无痛胃镜止血治疗急性非静脉曲张性上消化道出血不同给药方式疗效比较

Comparison of Clinical Efficacy of Hemostatic Treatment Under Painless Gastroscopy with the Different Administration Methods for Acute Non-Variceal Upper Gastrointestinal Bleeding

目的比较无痛胃镜下不同给药方式治疗急性非静脉曲张性上消化道出血的临床疗效。方法选取医院2019年3月至2020年1月收治的急性非静脉曲张性上消化道出血患者92例,按随机数字表法分为注射组和喷洒组,各46例。两组患者均在静脉滴注质子泵抑制剂的基础上行无痛胃镜止血治疗,喷洒组患者胃镜下喷洒注射用矛头蝮蛇血凝酶治疗,注射组患者胃镜下注射重酒石酸去甲肾上腺素注射液治疗。结果注射组总有效率为97.83%,显著高于喷洒组的91.30%(P<0.05)。治疗后,注射组患者出血停止时间为(1.37±0.29)d,显著短于喷洒组的(1.67±0.35)d(P<0.05);注射组患者5 min内出血停止率为95.65%,显著高于喷洒组的80.43%(P<0.05);注射组患者1周内再出血率为2.17%,显著低于喷洒组的15.22%(P<0.05)。治疗后,注射组和喷洒组患者血清内毒素和C反应蛋白水平均显著降低,且注射组显著更低(P<0.05)。注射组不良反应发生率为8.70%,显著低于喷洒组的23.91%(P<0.05)。结论与喷洒给药相比,无痛胃镜下采取注射给药方式治疗急性非静脉曲张性上消化道出血疗效更好,可显著降低患者的血清内毒素和C反应蛋白水平,且治疗安全性较好。

Objective To compare the clinical efficacy of hemostatic treatment under the painless gastroscopy with the different administration methods for acute non-variceal upper gastrointestinal bleeding(ANVUGIB).Methods A total of 92 patients with ANVUGIB admitted to the hospital from March 2019 to January 2020 were selected and divided into the injection group and the spraying group by the random number table method,with 46 cases in each group.The patients in the two groups were given the hemostatic treatment under the painless gastroscopy on the basis of intravenous drip of proton pump inhibitor.The patients in the spraying group were sprayed with Hemocoagulase Bothrops Atrox for Injection under the painless gastroscopy,while the patients in the injection group were injected with Norepinephrine Bitartrate Injection under the painless gastroscopy.Results The total effective rate in the injection group was 97.83%,which was significantly higher than 91.30%in the spraying group(P<0.05).After treatment,the stopping bleeding time in the injection group was(1.37±0.29)d,which was significantly shorter than(1.67±0.35)d in the spraying group(P<0.05).After treatment,the stopping bleeding rate within 5 min in the injection group was95.65%,which was significantly higher than 80.43%in the spraying group(P<0.05).After treatment,the rebleeding rate within one week in the injection group was 2.17%,which was significantly lower than 15.22%in the spraying group(P<0.05).After treatment,the levels of serum endotoxin and C-reactive protein(CRP)in the two groups were significantly lower,and those in the injection group were significantly lower than those in the spraying group(P<0.05).The incidence of adverse reactions in the injection group was 8.70%,which was significantly lower than 23.91%in the spraying group(P<0.05).Conclusion Compared with the administration of spraying,the administration of injection under the painless gastroscopy is more effective and safer in the treatment of ANVUGIB,which can significantly reduce the levels of serum endotoxin and CRP.