胃镜下喷洒凝血酶治疗溃疡性上消化道出血患者的效果  

Effects of endoscopic spraying of Thrombin in treatment of patients with ulcerative upper gastrointestinal bleeding

作　　者：张静文 ZHANG Jingwen(Department of Endoscopic Diagnosis and Treatment of Nanyang Second General Hospital,Nanyang 473000 Henan,China)

机构地区：[1]南阳市第二人民医院内镜诊疗科,河南南阳473000

出　　处：《中国民康医学》2023年第13期56-59,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨胃镜下喷洒凝血酶治疗溃疡性上消化道出血(UGIB)患者的效果。方法:选取2020年7月至2022年10月该院收治的108例溃疡性UGIB患者进行前瞻性研究,按照随机数字表法将其分为对照组、观察组各54例。两组均予以补液、抑酸、钛夹止血、电凝止血等常规治疗,在此基础上,对照组采用胃镜下喷洒肾上腺素治疗,观察组在对照组基础上采用胃镜下喷洒凝血酶治疗,均连续用药3 d。比较两组临床疗效、大便隐血转阴时间、呕血消失时间、住院时间,治疗前后凝血功能指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、凝血酶原时间(PT)]水平、血清炎性指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、前列腺素E2(PGE2)]水平,以及不良反应发生率。结果:观察组治疗总有效率为98.15%(53/54),高于对照组的85.19%(46/54),差异有统计学意义(P<0.05);治疗后,观察组大便潜血转阴时间、呕血消失时间、住院时间均短于对照组,PT、APTT值均小于对照组,FIB、D-D水平均高于对照组,差异有统计学意义(P<0.05);治疗后,观察组CRP、IL-6水平均低于对照组,PGE2水平高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:胃镜下喷洒凝血酶能改善溃疡性UGIB患者的凝血功能,减轻炎症反应,加快临床症状缓解,缩短住院时间,止血效果优于胃镜下喷洒肾上腺素治疗。Objective:To investigate effects of endoscopic spraying of Thrombin in treatment of patients with ulcerative upper gastrointestinal bleeding(UGIB).Methods:A prospective study was conducted on 108 patients with ulcerative UGIB admitted to this hospital from July 2020 to October 2022.These patients were divided into control group and observation group according to the random number table method,54 cases in each group.Both groups were given conventional treatment such as rehydration,acid suppression,titanium clip hemostasis,and electrocoagulation hemostasis.On this basis,the control group was treated with endoscopic spraying of Adrenaline,while the observation group was treated with endoscopic spraying of Thrombin on the basis of that of the control group.All patients were treated continuously for 3 d.The clinical efficacy,the fecal occult blood negative conversion time,the hematemesis disappearance time,the hospitalization time,the coagulation function index levels[activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D),prothrombin time(PT)],the serum inflammatory index levels[C-reactive protein(CRP),interleukin-6(IL-6),prostaglandin E2(PGE2)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 98.15%(53/54),which was higher than 85.19%(46/54)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the fecal occult blood negative conversion time,the hematemesis disappearance time and the hospitalization time in the observation group were shorter than those in the control group,the PT and APTT values were lower than those in the control group,the FIB and D-D levels were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CRP and IL-6 in the observation group were lower than those in the control group,the level of PGE2 was higher than that in the control group,and the

关 键 词：胃镜 凝血酶 消化性溃疡 上消化道出血 肾上腺素 

分 类 号：R574[医药卫生—消化系统]