内镜下金属钛夹止血治疗上消化道出血的临床疗效及对患者凝血功能的影响

Clinical Efficacy of Endoscopic Hemostasis with Metal Titanium Clip in the Treatment of Upper Gastrointestinal Bleeding and its Effect on Coagulation Function

目的研究内镜下金属钛夹止血与注射止血药物治疗上消化道出血临床疗效及对凝血功能的影响。方法选取2019年10月-2022年10月在我院诊治的60例上消化道出血患者为研究对象,采用随机数字表法分为对照组(n=30)和观察组(n=30),对照组采用内镜下注射止血药物治疗,观察组采用内镜下金属钛夹止血治疗。比较两组临床疗效、凝血功能指标[凝血酶原时间(PT)、纤维蛋白原(Fbg)、血小板(PLT)]、血红蛋白(Hb)水平、红细胞计数(RBC)、便血消失时间、住院时间、再出血发生率以及并发症发生率。结果观察组治疗总有效率(93.33%)高于对照组(83.33%)(P<0.05);2组PT小于治疗前,Fbg、PLT高于治疗前,且观察组PT小于对照组,Fbg、PLT大于对照组(P<0.05);2组Hb、RBC均低于治疗前,但观察组高于对照组(P<0.05);观察组便血消失时间、住院时间、再出血发生率均小于对照组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论上消化道出血采用内镜下金属钛夹止血效果显著,可提高治疗效果,缩短恢复时间,预防再出血,改善凝血功能指标,减小对血红蛋白和红细胞的影响,值得临床应用。

Objective To study the clinical efficacy of endoscopic hemostasis with metal titanium clip in the treatment of upper gastrointestinal bleeding and its effect on coagulation function.Methods From October 2019 to October 2022,60 patients with upper gastrointestinal bleeding diagnosed and treated in our hospital were selected as the research objects.They were divided into control group(n=30)and observation group(n=30)by random number table method.The control group was treated with endoscopic injection of hemostatic drugs,and the observation group was treated with endoscopic hemostasis with metal titanium clip.The clinical efficacy,coagulation function indexes[prothrombin time(PT),fibrinogen(Fbg),platelet(PLT)],hemoglobin(Hb)level,red blood cell count(RBC),disappearance time of hematochezia,hospitalization time,incidence of rebleeding and incidence of complications were compared between the two groups.Results The total effective rate of treatment in the observation group(93.33%)was higher than that in the control group(83.33%)(P<0.05).After treatment,PT in the two groups was lower than that before treatment,Fbg and PLT were higher than those before treatment,and PT in the observation group was lower than that in the control group,Fbg and PLT were higher than those in the control group(P<0.05).After treatment,Hb and RBC were lower than those before treatment,but those in the observation group were higher than the control group(P<0.05).The disappearance time of hematochezia,hospitalization time and the incidence of rebleeding in the observation group were less than those in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The hemostatic effect of endoscopic titanium clips is significant,which can improve the therapeutic effect,shorten the recovery time,prevent rebleeding,improve the coagulation function and reduce the Upper gastrointestinal bleeding on hemoglobin and red blood cells,it is worthy of clinical application.