内镜下OTSC吻合夹与常规内镜下止血治疗ANVUGIB患者的临床对比研究  

Clinical comparison of endoscopic OTSC anastomotic clip and conventional endoscopic hemostasis in the treatment of acute non-varicose upper gastrointestinal massive hemorrhage patients

作　　者：黄焕军 周杰[2] 杨文波 HUANG Huan-jun;ZHOU Jie;YANG Wen-bo(Department of Gastroenterology,Huazhong University of Science Tongji Hospital,Tongji Medical College,Wuhan,Hubei,430030;Department of Gastroenterology,Fuyang Central Hospital Wanshan Branch,Xiangyang,Hubei 441022)

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,430030 [2]襄阳市中心医院万山分院消化内科,441022

出　　处：《现代消化及介入诊疗》2019年第7期713-717,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的 研究内镜下OTSC吻合夹与常规内镜下止血治疗急性非静脉曲张性上消化道大出血(ANVUGIB)患者的临床疗效。方法 选取我院2016年3月至2018年3月收治的64例ANVUGIB患者纳入研究对象,以随机数表法分为观察组与对照组,每组32例。对照组于内镜下行常规止血治疗,观察组于内镜下使用OTSC吻合夹治疗。对比两组临床疗效及止血时间、住院时间、输血量各项指标,对比两组治疗前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、血浆纤维蛋白原(FIB)水平变化,另外统计两组住院期间并发症发生情况。结果 观察组临床疗效总有效率(93.75%)显著高于对照组(75.00%),差异有统计学意义(P<0.05)。观察组治疗期间止血时间、住院时间、输血量分别为(36.15±5.44)h、(8.84±2.33)d、(262.41±54.72)mL显著少于对照组,差异有统计学意义(P<0.05)。两组治疗后PT、APTT、D-D水平显著低于治疗前,差异有统计学意义(P<0.05);两组治疗后FIB水平显著高于治疗前,差异有统计学意义(P<0.05),组间比较,观察组PT、APTT、D-D、FIB与对照组比较,差异无统计学意义(P>0.05)。两组住院期间未出现消化道穿孔、消化道瘘等严重并发症。结论 内镜下OTSC吻合夹止血治疗ANVUGIB能够改善患者凝血功能、缩短住院时间,临床效果满意,其安全性较高,值得临床应用。Objective To study the clinical effect of endoscopic OTSC anastomotic clip and conventional endoscopic hemostasis in the treatment of acute non-varicose upper gastrointestinal massive hemorrhage (ANVUGIB). Methods 64 cases of ANVUGIB patients admitted to our hospital from March 2016 to March 2018 were selected as research objects,and were divided into observation group and control group by random number table method,32 cases in each group. The control group was treated with conventional hemostasis under endoscope,while the observation group was treated with OTSC anastomotic clamp under endoscope. The clinical efficacy,hemostasis time,hospitalization time and blood transfusion volume of the two groups were compared. The changes of prothrombin time (PT),activated partial thrombin time (APTT),d-dimer (D-D) and plasma fibrinogen (FIB) before and after treatment in the two groups were compared. In addition,the incidence of complications during hospitalization in the two groups was calculated. Results The total effective rate of the observation group was 93. 75%,which was significantly higher than that of the control group (75. 00%,P < 0. 05). The hemostasis time,hospitalization time and blood transfusion volume of the observation group were (36. 15 ± 5. 44) h,(8. 84 ± 2. 33) d,(262. 41 ± 54. 72) mL,significantly less than those of the control group (P < 0. 05).After treatment,PT,APTT and D-D levels in the two groups were significantly lower than before treatment,and the difference was statistically significant (P < 0. 05). After treatment,the FIB level of the two groups was significantly higher than that before treatment,and the difference was statistically significant (P < 0. 05). There was no significant difference in PT,APTT,D-D,FIB between the observation group and the control group (P > 0. 05). No serious complications such as digestive tract perforation and digestive tract fistula occurred in the two groups. Conclusion Endoscopic OTSC anastomotic clip for the treatment of acute non-varicose upper gastrointest

关 键 词：急性非静脉曲张性上消化道大出血 内镜 OTSC吻合夹 止血效果 

分 类 号：R573.1[医药卫生—消化系统]