急性非静脉曲张性上消化道出血内镜下止血治疗疗效分析  

Analysis of endoscopic hemostasis for acute nonvariiceal upper gastrointestinal bleeding

作　　者：单婕[1] 孙贤久[2] 闫红林[1] 杨永勤[1] 张婷[1] 

机构地区：[1]西安医学院附属医院内窥镜中心,西安710077 [2]中山大学附属东华医院消化内科

出　　处：《陕西医学杂志》2015年第1期39-41,共3页Shaanxi Medical Journal

摘　　要：目的:探讨内镜止血在急性非静脉曲张性上消化道出血治疗中的疗效。方法:对286例急性非静脉曲张性上消化道出血患者记录内镜诊断、病变部位、大小及近期出血征象等。病变出血征象采用Forrest分级,将所有患者随机分为内镜下止血治疗(治疗组)和保守治疗(对照组)。内镜止血治疗方法包括尼龙绳结扎止血、钛夹止血、注射止血、钛夹联合注射止血。结果:内镜治疗组进行内镜治疗的病变均为Forrest Ia^II b级,137例(95.8%)患者首次内镜止血成功,其中8例(5.6%)发生再出血,首次内镜治疗成功率为90.2%(129/143)。对照组首次止血成功117例,占81.8%,其中12例(8.4%)发生再出血,首次内镜治疗成功率为73.4%(105/143)。内镜治疗组与对照组相比较有显著性差异(P<0.05)。结论:内镜下止血治疗起效迅速、疗效确切,是急性非静脉曲张性上消化道出血患者的首选治疗方法;Forrest Ia^IIb级的出血病变应该进行内镜治疗。Objective：To evaluate the clinical effect of endoscopic hemostasis in acute nonvariceal upper gastrointestinal hemorrhage.Methods：This was a retrospective study of 286 patients with acute nonvariceal upper gastrointestinal bleeding and receiving endoscopic treatment who were admitted to our hospital.All patients were randomly divided into endoscopic therapy group and internal medicine conservative treatment group.Endoscopic treatment comprised nylon rope,titanium clips,injection,injection and combination therapy.Results：Hemorrhagic lesions were selected for endoscopic treatment,in which 137patients（95.8%,137/143）underwent first endoscopic hemostasis successfully,while rehemorrhage occurred in 8patients（5.6%,8/143）.The first hemostatic achievement rate was 90.2%（129/143）.In the control group 117patients（81.8%,117/143）underwent first endoscopic hemostasis successfull,while rehemorrhage occurred in 12patients（8.4%,12/143）.The first hemostatic achievement rate was 73.4%（105/143）.Endoscopic treatment group compared with the control group was statistically significant（P〈 0.05）.Conclusion：Endoscopic hemostatic therapy is the preferred emergency treatment in acute nonvariceal upper gastrointestinal bleeding.

关 键 词：消化性溃疡出血/治疗 内窥镜检查 消化系统 

分 类 号：R573.2[医药卫生—消化系统]