经内镜皮圈套扎治疗急性非静脉曲张性上消化道出血的应用价值

Application of Endoscopic Skin Snare in the Treatment of Acute Non varicose Upper Gastrointestinal Bleeding

目的探讨皮圈套扎止血在非静脉曲张性上消化道出血中的应用价值。方法选取2018年1月—2022年12月黔东南苗族侗族自治州人民医院确诊的微小病变致急性非静脉曲张性上消化道出血患者179例为研究对象,依据经内镜止血方法分为皮圈套扎治疗组(94例)、金属夹止血组(85例)。统计分析两组止血效果、症状消失时间、血液指标、并发症发生情况。结果皮圈套扎治疗组有效止血率为97.87%(92/94),高于金属夹止血组的83.53%(71/85),差异有统计学意义(χ^(2)=11.282,P<0.05)。皮圈套扎治疗组患者的引流变清、呕血消失、潜血转阴时间、住院时间均短于金属夹止血组,差异有统计学意义(P<0.05)。皮圈套扎治疗组患者的TNF-α、IL-6、CRP水平均低于金属夹止血组,差异有统计学意义(P<0.05)。皮圈套扎治疗组患者的并发症发生率1.06%(1/94)低于金属夹止血组9.41%(8/85),差异有统计学意义(χ^(2)=4.883,P<0.05)。结论非静脉曲张性上消化道出血可应用多种方法镜下止血,其中皮圈套扎治疗较金属夹止血操作简单、快捷,再出血率较低,且无明显严重的并发症。

Objective To investigate the application value of skin snare for hemostasis in non-varicose upper gastrointestinal bleeding.Methods From January 2018 to December 2022,179 patients with acute non-varicose upper digestive tract bleeding caused by minor lesions diagnosed in Qiandongnan Miao and Dong Autonomous Prefecture People′s Hospital were selected as the study subjects.According to endoscopic hemostasis,they were divided into skin snare group(94 cases)and metal clip hemostasis group(85 cases).Hemostatic effect,symptom disappearance time,blood indexes and complications of the two groups were statistically analyzed.Results Leather trap to plunge into the treatment group effective hemostatic rate was 97.87%(92/94),higher than the hemostatic clip group 83.53%(71/85),and the difference was statistically significant(χ^(2 )=11.282,P<0.05).The drainage clearing,hematemesis disappeared,the time of occult blood turning negative and the length of hospital stay in the skin snare treatment group were shorter than those in the metal clip hemostasis group,and the difference was statistically significant(P<0.05).The levels of TNF-α,IL-6 and CRP in skin snare treatment group were lower than those in metal clip hemostasis group,and the difference was statistically significant(P<0.05).The incidence of complications in skin snare treatment group was 1.06%(1/94)lower than that in the hemostatic clip group 9.41%(8/85),and the difference was statistically significant(χ^(2 )=4.883,P<0.05).Conclusion Non-varicose upper gastrointestinal bleeding can be stopped by a variety of methods under the lens,among which the treatment of skin snare is simpler and faster than metal clip hemostasis,the rebleeding rate is lower,and there are no obvious serious complications.