内镜引导黏膜下注射药物联合钛夹治疗十二指肠溃疡出血  

Curative effect analysis of endoscopic submucosal drug injection combined with titanium clip in the treatment of duodenal ulcer bleeding

作　　者：程莉莉 谭克文 张俊文[2] 陈奇 宋仁 代高举 刘锫 

机构地区：[1]重庆市垫江县人民医院消化内科,重庆垫江408300 [2]重庆医科大学附一院消化内科,重庆400042

出　　处：《西部医学》2016年第10期1405-1408,共4页Medical Journal of West China

基　　金：重庆市卫生局科研课题(20122308)

摘　　要：目的探讨经内镜引导黏膜下注射药物联合金属钛夹在十二指肠溃疡出血患者中临床治疗效果。方法将116例十二指肠溃疡出血患者根据其病情、意愿与经济承受能力分为内镜治疗组(内镜组)及单用药物治疗组(对照组)各58例,内镜组予以内镜引导黏膜下注射药物联合金属钛夹治疗,对照组予以内科药物奥美拉唑治疗。治疗后连续观察两组患者在止血的时间、住院时间、输血量等结果的差别。结果内镜组患者入院12小时内成功止血45例(77.59%);对照组患者入院12小时内成功止血仅15例(25.86%)。内镜组与对照组相比,止血效果具有显著性差异(P<0.05)。内镜组患者入院48小时后仍有活动性出血转外科手术治疗2例(3.45%);对照组患者入院48小时后仍有活动性出血转内镜治疗38例(65.51%)经内镜治疗后出血停止33例,转为外科手术治疗5例(8.62%)。内镜组止血的有效率明显高于对照组,差异具有显著的统计学意义(P<0.05)。内镜组输血量为(998.12±82.72)ml,对照组输血量为(1135.20±96.49)ml,内镜组住院时间平均(10.52±1.68)天,对照组住院时间平均(18.46±1.54)天,均有显著差异(P<0.05)。结论黏膜下注射药物联合金属钛夹对于治疗十二指肠溃疡出血患者可明显缩短出血时间和成功止血率,减少输血用量、缩短住院时间,是较好的临床治疗选择。Objective To evaluate the application of submucosal injection combined with metal titanium clip in the duodenal ulcer bleeding by endoscopy. Methods According to the patients＇ state of illness, wishes, and economic affordability points, 116 patients with acute duodenal ulcer bleeding were divided into endoscopic treatment group （endoscopic group） and single drug treatment group （control group）. Patients in endoscopic group were treated with submucosal injection combined with metal titanium clips, while the control group received medical treatment of drug omeprazole. The hemostatic time, hospitalization time and blood transfusion were observed. Results Compared with those of drug therapy, the hemostasis rate of endoscopic treatment group significantly increased, and the hospitalization time of endoscopic treatment group was significantly shortened, the transfusion blood volume of endoscopic treatment group decreased （P〈0.05）. Conclusion Submucosal injection combined with titanium clip for the treatment of duodenal ulcer hemorrhage is safe and effective.

关 键 词：十二指肠溃疡出血 粘膜下注射 金属钛夹 

分 类 号：R573.1[医药卫生—消化系统]