内镜下金属止血夹联合大剂量质子泵抑制剂治疗消化道出血的临床效果  

Clinical effect of endoscopic metal hemostatic clip combined with high-dose proton pump inhibitor in the treatment of gastrointestinal bleeding

作　　者：谢向忠 XIE Xiangzhong(Emergency Department,the Sixth People's Hospital of Jiaozuo,Jiaozuo 454001,China)

机构地区：[1]焦作市第六人民医院急诊科,河南焦作454001

出　　处：《临床医学研究与实践》2021年第30期67-69,共3页Clinical Research and Practice

摘　　要：目的探究内镜下金属止血夹联合大剂量质子泵抑制剂治疗消化道出血(GIB)的临床效果。方法将我院60例GIB患者随机分为常规组(内镜下金属止血夹联合常规剂量质子泵抑制剂)和大剂量组(内镜下金属止血夹联合大剂量质子泵抑制剂),各30例。比较两组患者的治疗效果。结果大剂量组患者治疗后24、48、72 h的止血率均高于常规组,止血失败后转手术治疗率低于常规组(P<0.05)。治疗72 h后,大剂量组患者空腹胃酸pH高于治疗前及常规组(P<0.05),而两组患者的收缩压、舒张压、丙谷转氨酶和血肌酐水平均无显著差异(P>0.05)。大剂量组患者呕血或黑便消失时间及住院时间均短于常规组,输血量少于常规组(P<0.05)。大剂量组患者治疗后72 h再出血率为0%,低于常规组的13.33%(P<0.05)。结论内镜下金属止血夹联合大剂量质子泵抑制剂能够快速提高GIB患者的胃内pH,止血迅速,且可降低短时间内再出血率,缩短住院时间。Objective To explore the clinical effect of endoscopic metal hemostatic clip combined with high-dose proton pump inhibitor in the treatment of gastrointestinal bleeding(GIB).Methods A total of 60 patients with GIB admitted to our hospital were randomly divided into conventional group(endoscopic metal hemostatic clip combined with conventional dose proton pump inhibitor)and high-dose group(endoscopic metal hemostatic clip combined with high-dose proton pump inhibitor),with 30 cases in each group.The treatment effects of the two groups were compared.Results The hemostatic rate at 24,48 and 72 h after treatment in the high-dose group were higher than those in the conventional group,and the rate of switching to surgery after hemostatic failure was lower than that in the conventional group(P<0.05).After 72 h of treatment,the fasting gastric acid pH in the high-dose group was higher than that before treatment and in the conventional group(P<0.05),but there were no significant differences in systolic blood pressure,diastolic blood pressure,the levels of alanine aminotransferase and serum creatinine between the two groups(P>0.05).The disappearance time of hematemesis or black stool and hospitalization time in the high-dose group were shorter than those in the conventional group,and the amount of blood transfusion was less than that in the conventional group(P<0.05).The rebleeding rate at 72 h after treatment in the high-dose group was 0%,which was lower than 13.33% in the conventional group(P<0.05).Conclusion Endoscopic metal hemostatic clip combined with high-dose proton pump inhibitor can quickly improve the intragastric pH of GIB patients,stop bleeding quickly,reduce the rebleeding rate in a short time,and shorten the hospital stay.

关 键 词：内镜下金属止血夹 大剂量质子泵抑制剂 消化道出血 

分 类 号：R573.2[医药卫生—消化系统]