胃镜联合去甲肾上腺素对溃疡性消化道出血患者疗效及炎性因子的影响价值  

Clinical effect of gastroscopy combined with norepinephrine on ulcerative gastrointestinal bleeding and its influence on inflammatory factors

作　　者：陈虹君[1] 李美鹚 CHEN Hong-jun;LI Mei-ci(Digestive endoscopy center,the Fifth Affiliated Hospital Sun Yat-sen University,Zhuhai,Guangdong 519000,China)

机构地区：[1]中山大学附属第五医院消化内镜中心,广东省珠海市519000

出　　处：《临床合理用药杂志》2018年第32期3-4,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察胃镜联合去甲肾上腺素治疗溃疡性消化道出血患者的临床效果。方法回顾性分析医院收治的溃疡性消化道出血患者82例临床资料,根据治疗方法不同分为对照组和观察组,每组41例。对照组采用单纯胃镜止血夹止血方案,观察组在对照组治疗基础上加用去甲肾上腺素注射止血,比较2组止血有效率和72 h再出血率,记录2组治疗前后IL-6、IL-8以及TNF-α数值,评价患者的炎性反应情况。结果观察组即时止血率为90.24%,高于对照组的56.10%(P<0.01);观察组72 h再出血率为4.88%,低于对照组的24.39%(P<0.05);治疗后,2组各项炎性因子指标(TNF-α、IL-6及IL-8)数值较治疗前均下降,且观察组较对照组明显更低(P均<0.01)。结论胃镜联合去甲肾上腺素注射止血能够有效提高患者的即时止血率,同时还能够降低患者的再出血率,是一种有效治疗溃疡性消化道出血的治疗方案,值得推广应用。Objective To observe the clinical effect of gastroscopy combined with norepinephrine in the treatment of ulcerative gastrointestinal bleeding and its influence on inflammatory factors.Methods The clinical data of 82 patients with ulcerative gastrointestinal bleeding were retrospectively analyzed.According to different treatment methods,they were divided into observation group and control group,41 cases in each group.The control group only used gastroscopy hemostatic clip to stop bleeding.The observation group was treated with norepinephrine for hemostasis on the basis of the control group.The effective rate of hemostasis and the rate of rebleeding within 72 hours were compared between the 2 groups.The levels of IL-6,IL-8 and TNF-α in 2 groups before and after treatment were recorded,and the occurrence of inflammatory reaction was evaluated.Results The hemostasis rate in the observation group was 90.24%,which was higher than 56.10% in the control group（P〈0.01）.The rebleeding rate of 72 h in the observation group was 4.88%,which was lower than 24.39% in the control group（P〈0.05）.After treatment,the index of inflammatory factors in both groups decreased compared with that before treatment,and the degree of decrease in the observation group was more obvious（P〈0.01）.Conclusion Gastroscopy combined with norepinephrine can effectively improve the immediate hemostasis rate of patients with ulcerative gastrointestinal hemorrhage,reduce the risk of re-bleeding,the effect is accurate,worthy of clinical application.

关 键 词：胃镜 止血夹止血 去甲肾上腺素 溃疡性消化道出血 

分 类 号：R573.1[医药卫生—消化系统]