消化内镜下两种类型止血夹治疗上消化道出血临床效果观察

Clinical Observation of Two Types of Hemostatic Clips Under Digestive Endoscopy in the Treatment of Upper Gastrointestinal Bleeding

目的:分析消化内镜下两种类型止血夹治疗上消化道出血的临床效果。方法:选取本院收治的104例上消化道出血患者为研究对象,按照入院顺序将其分为两组,两组患者均在消化内镜视野下采用止血夹进行止血治疗,对照组采用金属钛夹,研究组采用可旋转重复开闭软组织夹。观察两组患者止血情况、手术一般指标、血液指标和临床转归指标。结果:两组即时止血率差异无统计学意义(P>0.05)。研究组止血有效率和再出血率均显著优于对照组(P<0.05)。研究组止血夹使用数量、术中输血量、止血夹脱落时间和住院时间均显著优于对照组(P<0.05)。治疗后两组ALB和PLT差异均无统计学意义(P>0.05),研究组HGB显著高于对照组(P<0.05)。两组并发症发生率和再手术率差异均无统计学意义(P>0.05)。结论:可旋转重复开闭软组织夹具有更好的止血效果。

Objective:To analyze the clinical effects of two types of hemostatic clips under digestive endoscopy in the treatment of upper gastrointestinal bleeding.Methods:104 patients with upper gastrointestinal bleeding treated in our hospital were divided into two groups according to the order of admission.The patients were treated with hemostatic clamp under the field of digestive endoscopy,the control group was treated with metal titanium clamp,and the study group was treated with rotatable repeated opening and closing soft tissue clamp.The hemostasis,general surgical indexes,blood indexes and clinical outcome indexes of the two groups were observed.Results:There was no significant difference in the immediate hemostasis rate between the two groups(P>0.05).The effective rate of hemostasis and rebleeding rate in the study group were significantly better than those in the control group(P<0.05).The number of hemostatic clips used,the amount of intraoperative blood transfusion,the falling off time of hemostatic clips and the length of hospital stay in the study group were significantly better than those in the control group(P<0.05).After treatment,there was no significant difference in ALB and PLT between the two groups(P>0.05),and HGB in the study group was significantly higher(P<0.05).There was no significant difference in the incidence of complications and reoperation between the two groups(P>0.05).Conclusion:The rotatable and repeated opening and closing soft tissue clamp has better hemostatic effect.