内镜电凝止血与组织胶注射治疗上消化道溃疡伴出血的疗效观察

Efficacy of endoscopic electrocoagulation and tissue glue injection in the treatment of upper gastrointestinal ulcer with bleeding

目的观察内镜电凝止血术与内镜组织胶注射术治疗对消化性溃疡伴出血患者的临床疗效。方法回顾性分析2021年1月至2023年1月亳州市人民医院收治的因消化性溃疡所致上消化道出血的86例患者的临床资料,根据治疗方案的不同,将患者分为对照组(内镜组织胶注射)46例和观察组(内镜电凝止血)40例。统计并比较两组患者的一般基线资料(年龄、性别、体重指数、病程、Forrest分级、溃疡类型、血红蛋白水平)、疗效、术中内镜下止血率、术后1周内再出血率和异位栓塞率、病情康复相关指标(呕血消失时间、住院时间、潜血转阴时间)及不良反应发生率。结果两组患者的一般基线资料比较差异无统计学意义(P>0.05)。观察组的治疗总有效率高于对照组(P<0.05)。观察组的术中内镜下止血率显著高于对照组(P<0.05),术后1周内再出血率显著低于对照组(P<0.05),两组术后1周内异位栓塞率比较差异无统计学意义(P>0.05)。观察组的病情康复相关指标显著优于对照组(P<0.001)。两组患者的不良反应总发生率差异无统计学意义(P>0.05)。结论内镜电凝止血术较内镜组织胶注射术对消化性溃疡伴出血患者具有更好的止血效果,不但可以减少患者术后的再出血率,还能加快患者的康复进程。

Objective To observe the clinical efficacy of endoscopic electrocoagulation treatment protocol and endoscopic tissue glue injection treatment protocol in patients with peptic ulcer with bleeding.Methods The clinical data of 86 patients with upper gastrointestinal bleeding due to peptic ulcer who were admitted to Bozhou People′s Hospital from January 2021 to January 2023 were retrospectively analyzed.According to different treatment programs,all the patients were divided into the control group(which used endoscopic tissue glue injection treatment protocol,n=46)and the observation group(which used endoscopic electrocoagulation treatment protocol,n=40).General baseline data(age,gender,body mass index,disease duration,Forrest classification,type of peptic ulcer,hemoglobin level),clinical efficacy after treatment,intraoperative endoscopic hemostasis rate,rebleeding rate and probability of ectopic embolism within 1 week after operation,indicators related to recovery(time for the disappearance of vomited blood,hospitalization time,time for the conversion of occult blood),and the incidence of adverse reactions were collected and compared between the two groups.Results There were no statistically significant differences in the general baseline data between the two groups(P>0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).The intraoperative endoscopic hemostasis rate of the observation group was significantly higher than that of the control group(P<0.05),and the rebleeding rate in the postoperative period of 1 week was significantly lower than that of the control group(P<0.05),whereas there was no statistically significant difference in ectopic embolism rate in the postoperative period of 1 week between the two groups(P>0.05).The levels of condition recovery-related indicators in the observation group were significantly better than those in the control group(P<0.001).There was no statistically significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with endoscopic tissue glue injection,endoscopic electrocoagulation has a better hemostatic effect on patients with peptic ulcer with bleeding.It not only reduces the rebleeding rate,but also accelerates the recovery process of the patients.