内镜下电止血钳与注射肾上腺素联合金属夹治疗十二指肠球部溃疡急性出血的疗效比较  

Endoscopy hemostatic forceps versus and epinephrine injection used in combination with metal clip for treatment of acute bleeding from duodenal ulcer:a comparison of therapeutic efficacy

作　　者：杨成 陈斌[1] 卢如相[1] 刘胜雄 袁思婵 曾威龙 YANG Cheng;CHEN Bin;LU Ruxiang;LIU Shengxiong;YUAN Sichan;ZENG Weilong(GI Medicine,Yuebei People’s Hospital,Shaoguan,Guangdong 512000,China)

机构地区：[1]粤北人民医院消化内科,广东韶关512000

出　　处：《医药前沿》2022年第27期9-12,共4页Journal of Frontiers of Medicine

基　　金：韶关市卫生健康局科研项目(Y20210)。

摘　　要：目的:比较内镜下电止血钳与注射肾上腺素联合金属夹治疗十二指肠球部溃疡急性出血的疗效。方法:选取2020年1月—2021年6月粤北人民医院消化内科收治的十二指肠球部溃疡急性出血患者100例,随机分为电止血钳组和注射组各50例。电止血钳组给予电凝联合金属夹止血治疗,注射组给予注射肾上腺素联合金属夹治疗。比较两组止血操作消耗时间、止血率、再出血率、转外科及介入手术率以及并发症发生率。结果:两组的止血率均为100%,电止血钳组再出血率4%(2/50)、转外科及介入手术率2%(1/50),注射组再出血率6%(3/50)、转外科及介入手术率4%(2/50),差异均无统计学意义(P>0.05)。注射组内镜止血操作消耗时间(12.28±2.62)min短于电止血钳组(17.36±3.00)min,差异有统计学意义(P<0.05),注射组不良事件总发生率(14%)低于电止血钳组(34%),差异有统计学意义(P<0.05)。结论:给予十二指肠球部溃疡急性出血患者内镜下电止血钳联合金属夹或注射肾上腺素联合金属夹两种治疗方法均可起到良好的止血效果,但后者可缩短急诊止血操作时间,降低并发症发生率,值得临床应用。Objective To explore the clinical effect of endoscopy hemostatic forceps versus and epinephrine injection used in combination with metal clip for treatment of acute bleeding from duodenal ulcer.Method A total of 100 patients with duodenal ulcer bleeding admitted to Yuebei People’s Hospital from January 2020 to June 2021 were randomLy divided into Hemostatic forceps group and injection group,with 50 cases in each group.The Hemostatic forceps group was treated with electrocoagulation combined with metal clip,and the injection group was treated with epinephrine injection combined with metal clip.The consumption time of hemostatic operation,hemostatic rate,rebleeding rate,surgical transfer rate and interventional surgery rate,and complication rate were compared between the two groups.Result The hemostatic rate was 100%in both groups.The rate of rebleeding was 4%(2/50)and the surgical transfer and interventional surgery rate was 2%(1/50)in the Hemostatic forceps group,and 6%(3/50)and 4%(2/50)in the injection group.There was no significant difference between the two groups.The operation time of endoscopic hemostasis in the injection group(12.28±2.62 min)was significantly shorter than that in the Hemostatic forceps group(17.36±3.00 min)(P<0.05).The total incidence of adverse events in the injection group was 14%,which was significantly lower than that in the Hemostatic forceps group(34%)(P<0.05).Conclusion Both endoscopic hemostatic forceps combined with metal clip or injection of epinephrine combined with metal clip can achieve good hemostatic effect in patients with acute bleeding from duodenal ulcer.However,under the same circumstances,the operation time of the latter in emergency hemostasis is faster and the complications are less,which is worthy of clinical promotion.

关 键 词：十二指肠球部溃疡出血 电止血钳 金属夹 肾上腺素 内镜 

分 类 号：R632.1[医药卫生—外科学]