内镜随访检查对注射治疗出血性溃疡85例疗效观察

Endoscope follow-up examination to observe the efficacy of injection treatment in 85 cases of bleeding ulcer patients

目的 :研究内镜随访检查和重复注射治疗对出血性溃疡病人的疗效观察。方法 :将急诊内镜检查诊断为出血性消化性溃疡 85例 ,随机分成治疗组 4 3例 ,对照组 4 2例。治疗组应用稀释肾上腺素、组织硬化剂在内镜引导下注射到溃疡基底部 ,由于局部压迫作用使出血停止。治疗组预约时间内镜检查随访 ,再出血者给予重复注射治疗。对照组不作内镜检查随访。结果 :出血性溃疡病人经内镜注射治疗后 1 0～ 30 %再出血 ,溃疡局部特征改善未见取得较好的治疗效果 .两组病人无论接受内镜随访检查与否 ,再出血率无差异 (p >0 .5 ) ,病人之间在输血量、住院时间、转手术人数和死亡人数方面无统计学显著差异。结论 :出血性溃疡病人内镜下重复治疗明显降低再出血的发病率和死亡率。按照Forrset标准诊断的消化性溃疡出血病人首次内镜治疗成功后 。

Objective: To study the efficacy of endoscope follow-up examination and duplicated injection treatment in bleeing ulcer patients.Method: The 85 cases of bleeding peptic ulcer diagnosed by emergency endoscope examination randomely divided into treatment group including 43 cases and control group including 42 cases.In the treatment group we injected attrnuant adrenalin and tissue uulcanizer to the basilar part of the ulcer by guidance of the endoscope,which can stop bleeding by the effect of local compression.To the treatment group we made an appointment to follow-up endoscope examination and repeated the injection treatment to the secondary bleeding patients.But we hadn't follow-up of endoscope examination to the control group. Result:The bleeding ulcer patients had secondary bleeding at 10%～30% after injection treatment by endoscope.There wasn't better treatment efficacy in the local characteristic improvement of the ulcer. The rate of secondary bleeding between two groups had not difference (p>0.5),no matter whether the two groups accepted the follows-up of endoscope or not. There wasn't statistics marked discrepancy in volume of blood transfusion, hospitalization time,the number of accepted operation and mortality.Conclusion: Duplicated treatment of endoscope can reduce the incidence rate and mortality of secondary bleeding in the patients of bleeding peptic ulcer.The patients of bleeding peptic ulcer diagnosed by Forrset criterion are not recommended the procedural follow-up of endoscope after being treated successfully at first.