内镜下金属钛夹治疗急性非静脉曲张性上消化道出血的可行性及对患者止血效果和炎症状态的影响

The feasibility of endoscopy metal titanium clip treatment of acute non variceal upper gastrointestinal bleeding with titanium clips and its effect on hemostasis and inflammatory status

目的探讨内镜下金属钛夹治疗急性非静脉曲张性上消化道出血(acute non variceal upper gastrointestinal bleeding,ANVUGIB)的可行性及对患者止血效果和炎症状态的影响。方法选取2020年3月至2022年3月福建省龙岩人民医院内镜室收治的65例ANVUGIB患者作为研究对象,依据随机数字表法分为对照组(n=32)与观察组(n=33)。对照组给予注射肾上腺素止血,观察组给予内镜下金属钛夹止血。比较两组治疗后止血效果,治疗前后炎症因子水平、生命质量评分,随访期间的并发症发生情况。结果观察组临床有效率、临床止血率、及时止血率均高于对照组,外科再手术率、72 h再出血率均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清降钙素原(procalcito-nin,PCT)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组精力、躯体疼痛、一般健康状况、社会功能、生理职能、情感职能、精神健康、生理机能评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组随访期间并发症发生率比较差异无统计学意义。结论内镜下金属钛夹应用于ANVUGIB患者可增强临床止血效果,减轻患者炎症反应,提升生命质量,且安全性较高,值得临床推广应用。

Objective To investigate the feasibility of endoscopy metal titanium clip treatment of acute non variceal upper gastrointestinal bleed-ing(ANVUGIB)with titanium clips and its effect on hemostasis and inflammatory status.Methods 65 cases of ANVUGIB patients admitted to the endoscopy room in Longyan People Hospital of Fujian from March 2020 to March 2022 were selected as the research subjects,and they were divided into the control group(n=32)and the observation group(n=33)according to the random number table.The control group was treated with injection for hemostasis,and the observation group was treated with endoscopy metal titanium clip for hemostasis.The hemostatic effects,inflammatory factor lev-els,quality of life scores before and after treatment,and complications during follow-up were compared between the two groups.Results The clini-cal effective rate,clinical hemostasis rate and timely hemostasis rate in the observation group were higher than those in the control group,while the surgical reoperation rate and 72 h rebleeding rate were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of serum procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)of the two groups were lower than before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the scores of energy,body pain,general health status,social function,physiological function,emotional function,mental health and physiological function of the two groups were higher than before treatment,and the observation group was higher than the control group,the differences were sta-tistically significant(P<0.05).There was no difference in the statistical value of the total complication rate between the two groups during the fol-low-up period.Conclusion The application of endoscopy metal titanium clip in patients with ANVUGIB can improve the clinical hemostasis effect,reduce inflammatory reaction,improve the quality of life,and has high safety,it is worthy of clinical promotion and application.