内镜下注射硬化剂治疗非静脉曲张消化道出血的研究  

Endoscopic injection sclerotherapy in the treatment of nonvariceal gastrointestinal bleeding

作　　者：黄留业[1] 崔俊[1] 刘运祥[1] 宋波[1] 衣龙志[1] 徐宁[1] 张波[1] 吴承荣[1] 

机构地区：[1]山东省烟台毓璜顶医院消化内科,山东烟台264000

出　　处：《中国内镜杂志》2011年第4期347-350,共4页China Journal of Endoscopy

基　　金：2010年度烟台市科技发展计划资助No:2010148-13

摘　　要：目的探讨内镜下硬化剂局部注射在非静脉曲张消化道出血治疗中的价值。方法 82例患者随机分为治疗组及对照组,其中治疗组44例,给予内镜下注射硬化剂,对照组38例,给予内镜下注射1:10000肾上腺素,比较两组止血成功率,早期、近期、远期再出血率,并发症发生率及手术率等。结果治疗组止血成功率为97.7%,显著高于对照组(84.2%)(P=0.029)。治疗组早期再出血率为2.3%,显著低于对照组(15.6%)(P=0.036)。治疗组近期及远期再出血率均为2.3%,对照组近期及远期再出血率均为3.1%,差异无显著性(P=0.832)。治疗组及对照组均无死亡、穿孔及栓塞并发症出现,治疗组无心肺意外并发症出现,对照组出现窦性心动过速1例,发生率为2.6%,经内科保守治疗缓解,两组并发症发生率差异无显著性(P=0.279)。治疗组内科保守无效转外科手术率为2.3%,显著低于对照组(15.8%)(P=0.029)。结论内镜下注射硬化剂是治疗非静脉曲张消化道出血的一种安全有效的方法。[Objective] To observe the therapeutic effect and value of endoscopic injection in the treatment of nonvariceal gastrointestinal bleeding.[Methods] A total of 82 patients were randomly divided into therapy group and control group,44 patients in therapy group and 38 patients in control group.Patients in therapy group were treated with endoscopic sclerosing agent injection,those in control group were treated with endoscopic 1：10 000 epinephrine injection.The hemostasis rate,re-bleeding rate,complication rate and surgical operation rate were compared between the two groups.[Results] The hemostasis rate in therapy group was 97.7%,it was significantly higher than that of 84.2% in control group （P =0.029）.The rate of early re-bleeding in therapy group was 2.3%,which was significantly lower than that of 15.6% in control group （P =0.036）.The rate of re-bleeding in the near future and long-term in therapy group were both 2.3%,those in control group were both 3.1%,there was no significant difference （P =0.832）.There was no patient complicated of death,perforation and ectopic embolism in the two groups.No heart and lung accident occurred in therapy group,1 patient （2.6%） complicated of sinus tachycardia in control group,he was relieved with internal medicine therapy,the complication rate in the two groups was not significantly different （P =0.279）.Surgical operation rate in therapy group was 2.3%,it was significantly lower than that of 15.8% in control group （P =0.029）.[Conclusion] Endoscopic injection sclerotherapy is a kind of safe and effective method for the treatment of nonvariceal gastrointestinal bleeding.

关 键 词：非静脉曲张消化道出血 内镜下注射硬化术 

分 类 号：R573.2[医药卫生—消化系统]