内镜下钛夹联合质子泵抑制剂治疗非静脉曲张性上消化道出血的疗效  

Clinical effects of endoscopic titanium clipping combined with proton pump inhibitor therapy in treatment of non-variceal upper gastrointestinal bleeding

作　　者：靳玉红[1] 张彩凤[1] 李琨[1] 李贞娟[1] 高明[2] 常廷民[1] 

机构地区：[1]新乡医学院第一附属医院内镜科,河南省新乡市453000 [2]新乡医学院第一附属医院血液病研究室,河南省新乡市453000

出　　处：《世界华人消化杂志》2015年第13期2116-2120,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨内镜下钛夹联合质子泵抑制剂治疗非静脉曲张性上消化道出血的临床疗效.方法:将新乡医学院第一附属医院于2012-01/2013-12收治的146例急性非静脉曲张性上消化道出血患者根据治疗方法分为研究组和对照组,研究组(73例)采用内镜钛夹止血联合质子泵抑制剂治疗,对照组(73例)仅使用质子泵抑制剂进行治疗.评价两组患者治疗的有效率,比较止血时间、治疗出血量和总输血量,以及随访期内的再出血率和不良反应发生率.结果:研究组患者的治疗有效率明显高于对照组患者(P<0.05);前者的止血时间较对照组短,治疗中出血量和总输血量也明显少于对照组(P<0.05);研究组的再出血率低于对照组(P<0.05),两者不良反应的发生率差异没有统计学意义(P>0.05).结论:内镜下钛夹联合质子泵抑制剂治疗非静脉曲张性上消化道出血疗效较单用质子泵抑制剂高,其止血迅速有效,再出血的发生率低,无严重不良反应,值得临床推广应用.AIM： To evaluate the clinical effects of endoscopic titanium clipping combined with proton pump inhibitor therapy in the treatment of non-variceal upper gastrointestinal bleeding. METHODS： One hundred and forty-six patients with acute non-variceal upper gastrointestinal bleeding treated at our hospital from January 2012 to December 2013 were divided into a research group and a control group according to the method of treatment. The study group （73 cases） received endoscopic titanium clipping together with proton pump inhibitor therapy, and the control group （73 cases） only received proton pump inhibitor treatment. Treatment effectiveness, time to hemostasis, blood loss, total amount of blood transfusion, rebleeding rate, and incidence of adverse reactions during follow-up period were recorded and compared for the two groups. RESULTS： The effective rate in the research group was significantly higher than that in the control group （P 〈 0.05）. The time to hemostasis was significantly shorter and the blood loss and total amount of blood transfusion were significantly less in the research group than in the control group （P 〈 0.05）. The rebleeding rate in the research group was significantly lower than that in the control group （P 〈 0.05）, but no significant difference was found in the incidence of adverse reactions between the two groups （P 〉 0.05）. CONCLUSION： Endoscopic titanium clipping combined with proton pump inhibitor therapy has a higher effective rate than the single use of proton pump inhibitors in the treatment of non-variceal upper gastrointestinal bleeding, and the combination therapy is associated with a shorter time to hemostasis and a low incidence of rebleeding, withouth serious adverse reactions.

关 键 词：非静脉曲张性上消化道出血 内镜治疗 钛夹止血 质子泵抑制剂 

分 类 号：R573.2[医药卫生—消化系统]