内镜下氩离子凝固术联合肾上腺素治疗急性非静脉曲张性上消化道出血的效果  

Effect of Endoscopic Argon Ion Coagulation Combined with Epinephrine in the Treatment of Acute Non-varices Upper Gastrointestinal Bleeding

作　　者：闫登科[1] 黄瑞娜[1] YAN Dengke;HUANG Ruina(The Second Department of Gastroenterology,Pingdingshan First People’s Hospital,Pingdingshan 467000,China)

机构地区：[1]平顶山市第一人民医院消化内二科,河南平顶山467000

出　　处：《河南医学研究》2021年第17期3150-3153,共4页Henan Medical Research

摘　　要：目的探讨内镜下氩离子凝固术联合肾上腺素治疗急性非静脉曲张性上消化道出血的效果。方法回顾性选取平顶山市第一人民医院2018年7月至2019年9月收治的86例急性非静脉曲张性上消化道出血患者,根据治疗方法分为对照组(42例)和观察组(44例)。对照组接受1:10000肾上腺素治疗,观察组接受内镜下氩离子凝固术联合1:10000肾上腺素治疗。比较两组治疗效果、首次止血成功率、再出血率、住院时间、胃肠功能恢复时间、血清相关因子[胃蛋白酶原(PG)Ⅰ、胃泌素(G)-17]水平、预后情况(Rockall评分)。结果观察组治疗总有效率高于对照组(97.73%比77.27%,P<0.05)。观察组首次止血成功率高于对照组(100.00%比83.33%,P<0.05)。观察组住院时间、胃肠功能恢复时间较对照组短(P<0.05)。观察组再出血率低于对照组(0比14.29%,P<0.05)。治疗后7 d两组血清PGⅠ、G-17水平高于治疗前,且观察组高于对照组(P<0.05);治疗后两组Rockall评分均降低,且观察组低于对照组(P<0.05)。结论内镜下氩离子凝固术联合1:10000肾上腺素治疗急性非静脉曲张性上消化道出血患者,首次止血成功率高,可减少再出血的发生,缩短康复进程,促进消化道功能恢复,改善预后。Objective To investigate the effect of endoscopic argon ion coagulation combined with epinephrine in the treatment of acute non-varices upper gastrointestinal bleeding.Methods A total of 86 patients with acute non-varices upper gastrointestinal bleeding from July 2018 to September 2019 were selected in Pingdingshan First People’s Hospital.They were divided into two groups according to treating methods.The control group(42 patients)received 1:10000 adrenaline,the observation group(44 patients)received internal endoscopic argon ion coagulation combined with 1:10000 epinephrine.The treatment effect,first hemostatic success rate,rebleeding rate,hospitalization time,gastrointestinal function recovery time,serum level of pepsinogen(PG)Ⅰand gastrin(G)-17 and prognosis(Rockall score)were compared between the two groups.Results The total effective rate of treatment in observation group was higher than that in control group(97.73%vs.77.27%,P<0.05).The first hemostatic success rate in observation group was higher than that in control group(100.00%vs.83.33%,P<0.05).Hospitalization time and gastrointestinal function recovery time in observation group were shorter than those in control group(P<0.05).Rebleeding rate in observation group was lower than that in control group(0 vs.14.29%,P<0.05).After the treatment,Serum PGⅠand G-17 levels were higher,and the levels in observation group were higher than those in control group(P<0.05).The Rockall score in observation group was lower than that in control group(P<0.05).Conclusion Endoscopic argon ion coagulation combined with 1:10000 adrenaline could improve the success rate of first hemostasis,prevent rebleeding,shorten the recovery process,and promote the recovery and improvement of gastrointestinal function prognosis in patients with acute non-varices upper gastrointestinal bleeding.

关 键 词：急性非静脉曲张性上消化道出血 肾上腺素 内镜下氩离子凝固术 

分 类 号：R573.2[医药卫生—消化系统]