胃镜下注射肾上腺素与钛夹联合治疗急性非静脉曲张性上消化道出血的效果研究

Study on effect of epinephrine injection combined with titanium clip under gastroscope in the treatment of acute non-varicose upper gastrointestinal bleeding

目的分析胃镜下注射肾上腺素与钛夹联合治疗急性非静脉曲张性上消化道出血(ANVUGIB)的效果。方法98例急性非静脉曲张性上消化道出血患者作为研究对象,按照随机数字表法分为对照组与研究组,每组49例。对照组采用胃镜下钛夹治疗,研究组采用胃镜下注射肾上腺素与钛夹联合治疗。比较两组患者的止血效果、血红蛋白水平、大便潜血转阴时间、住院时间及不良反应发生情况。结果两组即时止血率比较,差异无统计学意义(P>0.05);研究组有效止血率69.39%高于对照组的46.94%,无效止血率4.08%低于对照组的38.78%,差异具有统计学意义(P<0.05)。治疗72 h后,研究组血红蛋白(116.52±15.56)g/L高于对照组的(98.50±12.65)g/L,差异具有统计学意义(P<0.05)。研究组大便潜血转阴时间(4.32±0.75)d、住院时间(9.52±1.02)d短于对照组的(6.65±0.80)、(13.65±1.54)d,差异具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论胃镜下注射肾上腺素与钛夹联合治疗急性非静脉曲张性上消化道出血具有显著的止血效果,可以有效改善患者的血红蛋白水平,缩短大便潜血转阴时间与住院时间,适于临床应用与推广。

Objective To analyze the effect of epinephrine injection combined with titanium clip under gastroscope in the treatment of acute non-varicose upper gastrointestinal bleeding(ANVUGIB).Methods A total of 98 patients with acute non-varicose upper gastrointestinal bleeding were divided into control group and research group according to the random numerical table,with 49 cases in each group.The control group was treated with titanium clip under gastroscope,and the research group was treated with epinephrine injection combined with titanium clip under gastroscope.Both groups were compared in terms of hemostatic effect,hemoglobin level,time for negative-conversion of fecal occult blood,length of hospital stay,and occurrence of adverse reactions.Results There was no statistically significant difference in the immediate hemostatic rate between the two groups(P>0.05).The effective hemostatic rate of 69.39%in the research group was higher than that of 46.94%in the control group,and the ineffective hemostatic rate of 4.08%was lower than that of 38.78%in the control group.The differences were statistically significant(P<0.05).After 72 h of treatment,hemoglobin of(116.52±15.56)g/L in the research group was higher than that of(98.50±12.65)g/L in the control group,and the difference was statistically significant(P<0.05).The time for negative-conversion of fecal occult blood of(4.32±0.75)d and length of hospital stay of(9.52±1.02)d in the research group were shorter than those of(6.65±0.80)and(13.65±1.54)d in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Epinephrine injection combined with titanium clip under gastroscope has significant hemostatic effect in the treatment of acute non-varicose upper gastrointestinal bleeding,and can effectively improve hemoglobin level,shorten the time for negative-conversion of fecal occult blood and length of hospital stay,which is suitable for clinical promotion.