消化内镜下钛夹止血术治疗胃十二指肠出血的临床效果

Clinical Effect of Titanium Clip Hemostasis under Digestive Endoscopy in the Treatment of Gastroduodenal Bleeding

目的:探讨消化内镜下钛夹止血术治疗胃十二指肠出血的临床效果。方法:选取2018年12月-2019年12月解放军总医院第八医学中心收治的胃十二指肠出血患者100例为观察对象,采用随机数字表法分为研究组和对照组,各50例。对照组实施常规止血处理,研究组实施消化内镜下钛夹止血术处理,比较两组患者临床效果、临床指标、应激反应指标、住院指标及并发症发生率。结果:研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组患者初次止血、再次出血、转急诊手术和死亡情况比较,差异无统计学意义(P>0.05);治疗后,两组患者皮质醇、去甲肾上腺素、肾上腺素水平均降低,研究组低于对照组,差异有统计学意义(P<0.05);研究组出血量、输血量少于对照组,止血用时、住院时间短于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:胃十二指肠出血在消化内镜下进行钛夹止血术处理效果显著,可减少出血量及输血量,缩短止血用时、住院时间,稳定应激水平,减少并发症发生率。

Objective:To explore the clinical effect of titanium clip hemostasis under digestive endoscope in the treatment of gastroduodenal hemorrhage.Methods:From December 2018 to December 2019,100 patients with gastroduodenal hemorrhage admitted to the Eighth Medical Center of PLA General Hospital were selected as the observation objects,and were divided into the research group and the control group by random number table method,with 50 cases in each group.The control group received routine hemostasis treatment,and the research group received titanium clip hemostasis treatment under digestive endoscopy.The clinical effects,clinical indicators,stress response indicators,hospitalization indicators and incidence of complications were compared between the two groups.Results:The total effective rate of the research group was higher than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference in the first hemostasis,rebleeding,transfer to emergency operation and death between the two groups(P>0.05).After treatment,the levels of cortisol,norepinephrine,and epinephrine in the two groups decreased,and the research group was lower than the control group,with statistically significant differences(P<0.05).The amount of blood loss and blood transfusion in the research group were less than those in the control group,and the time for hemostasis and hospital stay were shorter than those in the control group,the difference was statistically significant(P<0.05).The incidence of complications in the research group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Gastroduodenal hemorrhage is treated with titanium clip hemostasis under digestive endoscopy,which can reduce the amount of bleeding and blood transfusion,shorten the time for hemostasis and hospitalization,stabilize the stress level,and reduce the incidence of complications.