内镜下注射治疗消化性溃疡出血与Forrest分级的关系  

Study on injection therapy of Forrest graded peptic ulcer bleeding under endoscopy

作　　者：何剑琴[1] 李俊达[1] 

机构地区：[1]广东省深圳市第四人民医院消化内科,518033

出　　处：《中国实用医药》2008年第16期6-7,共2页China Practical Medicine

摘　　要：目的探讨消化性溃疡出血患者行急诊内镜下注射治疗与Forrest分级的关系,评估不同Forrest分级溃疡出血患者急诊内镜下注射治疗的必要性。方法选自2004年1月至2007年1月因呕血和(或)黑便入院,经急诊内镜检查确诊为溃疡性出血患者285例,溃疡出血按Forrest镜下表现分级,内镜注射止血治疗组145例,内科治疗组140例。结果内镜组145例,止血成功率95.9%,对照组140例,止血成功率80.0%,两组差异有统计学意义(P<0.05)。其中ForrestI级、Ⅱa级内镜组止血成功率(29/32、18/21)均高于对照组(13/28、12/19),Ⅱb级、Ⅱc级与Ⅲ级两组无明显差异。结论内镜注射止血治疗简单有效,优于单纯药物治疗,镜下表现为ForrestI级和Ⅱa级的溃疡出血患者,内镜下注射治疗是有效且必要的。Objective To study the therapeutic effect of endoscopic injection on Forrest graded peptic ulcer bleeding and evaluate its significance. Methods From Jan 2004 to Jan 2007,285 patients with haematemesis and/or hematochezia diagnosed as peptic ulcer by immediate endoscopy were divided into two groups based on Forrest grading, 145 cases were treated with injection therapy（ injection group） ;other 140 with conservative therapy only（ control group）. Results The haemostatie rates in injection therapy group and control group were 95.9% and 80.0% respectively with prominent statistical difference （ P 〈 0. 05 ） and between Forrest grade Ⅰ and Ⅱ a also with prominent statistical difference,hut no statistical difference between Forrest grade Ⅱ b、 Ⅱ e and Ⅲ. Conclusion Endoscopic injection therapy is an effective measure for bleeding peptic ulcer with Forrest grade Ⅰ and Ⅱ a,and is highly superior to the conservative therapy.

关 键 词：溃疡 出血 止血 内窥镜 

分 类 号：R573.1[医药卫生—消化系统]