应用纤维蛋白黏合剂治疗上消化道溃疡出血的临床研究  

The treatment of upper gastrointestinal ulcer bleeding with fibrin sealant

作　　者：蔡莉[1] 毛苇[2] Cai Li;Mao Wei(Blood Purification Center, Hainan General Hospital,Haikou 570311, China)

机构地区：[1]海南省人民医院血液净化中心,海口570311 [2]海南省人民医院内镜中心,海口570311

出　　处：《新医学》2019年第6期432-436,共5页Journal of New Medicine

基　　金：海南省自然科学基金(817303)

摘　　要：目的探讨内镜下纤维蛋白黏合剂治疗上消化道溃疡出血的疗效。方法选取因上消化道溃疡出血行急诊内镜治疗的84例患者作为研究对象。患者分别采用纤维蛋白黏合剂(40例,观察组)和肾上腺素联合热止血钳治疗(44例,对照组)。观察2组患者内镜手术完成率、手术时间、手术止血成功率和72h再出血率。结果观察组的手术完成率高于对照组(100.0% vs.86.4%,P=0.027),手术时间短于对照组[(3.6±0.6)min vs.(8.6±1.0)min,P<0.001]。观察组的手术止血率和72h再出血率分别为95.0%和10.5%,对照组分别为100.0%和0%,差异均无统计学意义(P均>0.05)。结论纤维蛋白黏合剂能够有效治疗胃十二指肠溃疡出血,而且由于其操作时间较短,尤其适用于难以耐受长时间治疗的患者,是一种较好的内镜止血手段。Objective To investigate the curative effect of endoscopic fibrin sealantin the treatment of upper gastrointestinal ulcer bleeding.Methods 84 patients treated by emergency endoscopic treatment for upper gastrointestinal ulcer bleeding were selected. The patients treated with fibrin sealant were included (n = 40, observation group) and treated with adrenaline combined with hot hemostatic forceps were included (n = 44, control group). The completion rate of endoscopic surgery, surgical time, the success rate of hemostasis and the 72 h rebleeding rate in the two groups were observed.Results The operative completion rate of the observation group was higher than control group (100.0% vs. 86.4%, P = 0.027). The operation time of the observation group was shorter than that of the control group [(3.6 ± 0.6) min vs.(8.6±1.0) min, P < 0.001). The hemostasis rates of the observation group and the control group were 95.0% and 100.0%, respectively. The 72h rebleeding rates of the observation group and the control group were 10.5% and 0%, respectively, there was no significant difference between the two groups (both P > 0.05). Conclusions Fibrin sealant is effective in the treatment of gastric and duodenal ulcer bleeding, and the surgical time is short. It is especially suitable for patients who cannot tolerate long-time treatment. It is a relatively better endoscopic hemostatic method.

关 键 词：纤维蛋白黏合剂 消化性溃疡 出血 

分 类 号：R573.1[医药卫生—消化系统]