消化内镜联合四联疗法对胃溃疡出血的治疗效果和再出血的原因分析  

Digestive endoscopic therapy combined with quadruple therapy for gastric ulcer bleeding and analysis of causes of rebleeding

作　　者：斯轶凡[1] 王农荣[1] 谢桂生[1] Si Yifan;Wang Nongrong;Xie Guisheng(Department of Gastroenterology,Fourth Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330003,China)

机构地区：[1]南昌大学第四附属医院消化内科,江西南昌330003

出　　处：《当代医学》2019年第12期56-58,共3页Contemporary Medicine

摘　　要：目的探讨消化内镜联合四联疗法对胃溃疡出血的治疗效果和再出血的原因。方法选取本院在2016年6月至2017年6月期间收治的90例胃溃疡出血患者作为研究对象,通过随机数字表法分为观察组(45例)和对照组(45例),对照组患者给予四联疗法治疗,观察组患者采取消化内镜联合四联疗法治疗,对比两组患者治疗的临床疗效并通过多元Logistic回归分析影响治疗后再出血的相关因素。结果观察组有效率95.56%高于对照组77.78%,差异有统计学意义(P<0.05),由单因素分析显示,出血量及溃疡AI期、血小板水平、血红蛋白含量、未联合内镜治疗等均是属于治疗后再出血的影响因素,通过多因素Logistic回归分析发现溃疡AI期及血红蛋白含量低、未联合内镜治疗属于影响胃溃疡患者治疗后再出血的独立危险因素(P<0.05)。结论消化内镜联合四联疗法对胃溃疡出血的治疗效果较好,有效的降低了再出血的发生率,且溃疡AI期和血红蛋白含量低为患者再出血的相关危险因素。Objective To investigate the effect of digestive endoscopy combined with quadruple therapy on gastric ulcer bleeding and the causes of rebleeding. Methods 90 cases of gastric ulcer bleeding treated in our hospital from June 2016 to June 2017 were selected as the research objects.The patients were divided into the observation group(45 cases) and the control group(45 cases) by the random digital table method. The control group was treated with quadruple therapy. The patients in the observation group were treated with digestive endoscopy combined with quadruple therapy, and the two groups were compared. The clinical efficacy of treatment was analyzed and multivariate Logistic regression analysis was used to analyze the related factors of rebleeding after treatment. Results The effective rate of the observation group was 95.56% higher than that of the control group(77.78%). The difference was statistically significant(P<0.05). The single factor analysis showed that the amount of bleeding and the AI stage of ulceration, the level of platelet, the content of hemoglobin, and the non combined endoscopy were all the factors of rebleeding after treatment, and were divided by multiple factor Logistic regression. It was found that the AI stage of ulcer and low hemoglobin content and non combined endoscopic treatment were independent risk factors for rebleeding after treatment in patients with gastric ulcer(P<0.05). Conclusion Digestive endoscopy combined with quadruple therapy has better effect on gastric ulcer bleeding, effectively reducing the incidence of rebleeding, and the associated risk factors of rebleeding in patients with AI stage and low hemoglobin content.

关 键 词：消化内镜 四联疗法 胃溃疡出血 临床疗效 再出血原因 

分 类 号：R573.1[医药卫生—消化系统]