内镜金属止血夹联合硬化剂注射治疗95例溃疡性上消化道出血患者的临床效果观察  

Clinical observation on 95 cases of ulcerative upper gastrointestinal bleeding treated by endoscopic metal hemostatic clip combined with sclerosing agent injection

作　　者：韩敏 张顺利 Han Min;Zhang Shunli(Qinghai Red Cross Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海红十字医院,青海西宁810000

出　　处：《首都食品与医药》2023年第22期21-24,共4页Capital Food Medicine

摘　　要：目的探讨内镜金属止血夹联合硬化剂注射治疗溃疡性上消化道出血患者的临床效果。方法选择青海红十字医院2021年1月-2023年1月收治的95例患者随机分为观察组(n=48)和对照组(n=47)。对照组给予内镜下硬化剂注射治疗,观察组在此基础上联合内镜金属止血夹治疗。观察比较两组临床疗效、凝血功能(PT、APTT、TT、FIB)、症状改善情况(止血时间、引流管液变清时间、大便潜血转阴时间、住院时间)及不良反应发生情况。结果观察组有效率为95.83%,明显高于对照组的85.11%(Z=-3.641,P=0.000)。治疗后,两组患者PT、APTT、TT及FIB与治疗前比较均下降(P<0.05);且观察组各项指标明显低于对照组(t=-16.391,P=0.000;t=-13.298,P=0.000;t=-21.737,P=0.000;t=-15.293,P=0.000)。观察组止血时间和引流管液变清时间分别为(11.35±1.68)h、(21.75±2.72)h,均短于对照组的(16.04±1.93)h和(26.84±3.25)h(t=-12.623,P=0.000;t=-8.269,P=0.000);同时,观察组大便潜血转阴时间(4.41±0.89)d,优于对照组的(7.06±1.23)d(t=-12.009,P=0.000);住院时间较对照组更短[(9.13±1.18)d VS(12.47±1.36)d](t=-12.774,P=0.000)。观察组发热、感染及穿孔等不良反应发生率为4.17%,低于对照组的17.02%(χ^(2)=4.166,P=0.041)。结论内镜金属止血夹联合硬化剂注射治疗溃疡性上消化道出血临床疗效显著,可有效发挥止血效果,改善患者临床症状,促进大便潜血快速转阴和机体凝血功能恢复,安全性高,值得推广应用。Objective This study aims to explore the clinical effect of endoscopic metal hemostatic clip combined with sclerosing agent injection in the treatment of ulcerative upper gastrointestinal bleeding.Method This study selected 95 patients admitted to our hospital from January 2021 to January 2023 and randomly divided them into an observation group(n=48)and a control group(n=47).The control group was treated with endoscopic sclerotherapy injection,while the observation group was treated with endoscopic metal hemostatic clips on this basis.It observed and compared the clinical efficacy,coagulation function(PT,APTT,TT,FIB),symptom improvement(hemostasis time,drainage tube fluid clearing time,fecal occult blood turning negative time,hospitalization time).In addition,the incidence of adverse reaction between the two groups.Results The effective rate of the observation group was 95.83%,significantly higher than that of the control group(85.11%,Z=-3.641,P=0.000).After treatment,PT,APTT,TT and FIB in both groups of patients decreased compared to before treatment(P<0.05).And,all indicators in the observation group were significantly lower than those in the control group(t=-16.391,P=0.000;t=-13.298,P=0.000;t=-21.737,P=0.000;t=-15.293,P=0.000).The hemostatic time and drainage tube clear time in the observation group were(11.35±1.68)hours and(21.75±2.72)hours,respectively,which were shorter than the(16.04±1.93)hours and(26.84±3.25)hours in the control group(t=-12.623,P=0.000;t=-8.269,P=0.000).At the same time,the time for fecal occult blood to turn negative in the observation group was(4.41±0.89)days,which was better than the control group's(7.06±1.23)days(t=-12.009,P=0.000).The hospitalization time was shorter than that of the control group(9.13±1.18)days VS(12.47±1.36)days(t=-12.774,P=0.000).The incidence of adverse reaction such as fever,infection,and perforation in the observation group was 4.17%,lower than 17.02%in the control group(χ^(2)=4.166,P=0.041).Conclusion Endoscopic metal hemostatic clip combined with scl

关 键 词：内镜金属止血夹 硬化剂 溃疡性上消化道出血 机械止血 凝血功能 

分 类 号：R573.2[医药卫生—消化系统]