内镜OTSC吻合夹联合肾上腺素治疗消化性溃疡活动性出血的效果观察

摘要/Abstract

摘要： 目的探讨内镜OTSC吻合夹联合肾上腺素治疗消化性溃疡活动性出血的临床效果。方法选取2020年3月~2022年3月在玉树州人民医院就诊的消化性溃疡活动性出血患者70例,采用随机数表法分为观察组[肾上腺素+OTSC吻合夹+质子泵抑制剂（PPI）]和对照组（肾上腺素+PPI）,各35例。对比两组临床疗效、治疗指标、血红蛋白和血细胞比容水平、凝血功能指标及不良反应发生情况。结果两组总有效率比较,差异无统计学意义（P>0.05）。观察组呕血消失时间、黑便消失时间、止血时间、住院时间和再出血率与对照组比较,均显著减少,差异有统计学意义（P<0.05）。治疗前,两组血细胞比容和血红蛋白水平比较,差异无统计学意义（P>0.05）;治疗后,两组血细胞比容和血红蛋白均显著高于治疗前,且观察组血细胞比容和血红蛋白均显著高于对照组,差异有统计学意义（P<0.05）。治疗后,与对照组比较,观察组凝血酶原时间（PT）、凝血酶时间（TT）均显著降低,纤维蛋白原（Fib）和血小板（PLT）均显著升高,差异有统计学意义（P<0.05）。两组不良反应发生率比较,差异无统计学意义（P>0.05）。结论内镜OTSC吻合夹联合肾上腺素治疗消化性溃疡活动性出血的效果显著且安全性良好,同时可以提高血细胞比容和血红蛋白的水平,改善患者的凝血功能,值得临床应用。

关键词: 消化性溃疡, 活动性出血, OTSC吻合夹, 内镜, 肾上腺素

Abstract: Objective To investigate the clinical effect of endoscopic OTSC anastomosis clip combined with epinephrine in the treatment of active bleeding of peptic ulcer. Methods A total of 70 patients with active peptic ulcer bleeding who were treated in Yushu People’s Hospital from March 2020 to March 2022 were selected and randomly number table method divided into observation group [(adrenaline+OTSC anastomosis clip+proton pump inhibitor (PPI)] and control group (adrenaline+PPI) 35 cases each. The clinical efficacy, treatment indexes, hemoglobin and hematocrit levels, coagulation function index and adverse reactions were compared between the two groups. Results There was no significant difference in the total effective rate between the two group (P>0.05). Compared with the control group, the disappearance time of hematemesis, black stool, hemostasis, hospital stay and rebleeding rate in the observation group were significantly reduced (P<0.05). There was no significant difference in hematocrit and hemoglobin levels between the two groups before treatment (P>0.05). After treatment, the hematocrit and hemoglobin in the two groups were significantly higher than those before treatment (P<0.05), and the hematocrit and hemoglobin in the observation group were significantly higher than those in the control group (P<0.05). After treatment, compared with the control group, Pt and TT in the observation group decreased significantly (P<0.05), and Fib and PLT increased significantly (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Endoscopic OTSC anastomosis clip combined with epinephrine has significant effect and good safety in the treatment of active bleeding from peptic ulcer. At the same time, it can improve the level of hematocrit and hemoglobin, and improve the coagulation function of patients, which is worthy of clinical application.

Key words: peptic ulcer, active bleeding, OTSC anastomosis clip, endoscopy, epinephrine

中图分类号:

R573.2

尕松永措. 内镜OTSC吻合夹联合肾上腺素治疗消化性溃疡活动性出血的效果观察[J]. 中华养生保健, 2022, 40(23): 7-11.

Gasongyongcuo. Effect of Endoscopic OTSC Anastomosis Clip Combined with Epinephrine on Active Bleeding of Peptic Ulcer[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(23): 7-11.

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