内镜下不同钛夹封闭时间对NVUGIB患者止血有效率及再出血率的影响  

Effect of titanium clip closure time under different endoscopy on hemostasis efficiency and rebleeding rate in patients with NVUGIB

作　　者：兰春梅 李煜 郑天翔 涂建军[2] LAN Chunmei;LI Yu;ZHENG Tianxiang;TU Jianjun(Department of Gastroenterology,Shaowu Municipal Hospital of Nanping City,Nanping,Fujian 354000,China;Department of Gastroenterology,the First Hospital of Nanping,Nanping City,Fujian 353000,China)

机构地区：[1]福建省南平市邵武市立医院消化内科,福建南平354000 [2]福建省南平市第一医院消化内科,福建南平353000

出　　处：《检验医学与临床》2024年第13期1960-1963,共4页Laboratory Medicine and Clinic

基　　金：福建省自然科学基金资助项目(2021J011424)。

摘　　要：目的探讨内镜下不同钛夹封闭时间对非静脉曲张性上消化道出血(NVUGIB)止血有效率及再出血率的影响。方法选回顾性选取2020年3月到2023年3月福建省南平市邵武市立医院收治的96例NVUGIB患者为研究对象,根据内镜下钛夹封闭时间分为早期组(50例,入院后6~<12 h进行治疗)及常规组(46例,入院后12~24 h进行治疗)。比较两组治疗后止血有效率、治疗前后免疫因子水平、治疗后再出血率。结果治疗后,早期组止血有效率为98.00%,明显高于常规组的82.61%,差异有统计学意义(χ^(2)=4.991,P=0.025)。治疗前,两组CD3^(+)、CD4^(+)、NK细胞水平比较,差异均无统计学意义(P>0.05)。治疗后,两组CD3^(+)、CD4^(+)、NK细胞水平均高于治疗前,且早期组均高于常规组,差异均有统计学意义(P<0.05)。治疗后,早期组总再出血率为4.00%,低于常规组的21.74%,差异有统计学意义(χ^(2)=6.892,P=0.008)。结论入院后6~<12 h内对NVUGIB患者进行内镜下钛夹封闭能有效提高NVUGIB止血有效率,改善患者免疫功能,降低再出血发生率,有利于改善患者预后。Objective To investigate the effect of titanium clip closure time under different endoscopy on the hemostatic efficiency and rebleeding rate of non-variceal upper gastrointestinal bleeding(NVUGIB).Methods A total of 96 patients with NVUGIB admitted to Shaowu Municipal Hospital of Nanping City,Fujian Province from March 2020 to March 2023 were retrospectively selected as the research objects.According to the time of endoscopic titanium clip closure,they were divided into the early group(50 cases,treated 6-<12 hours after admission)and the conventional group(46 cases,treated 12-24 hours after admission).The hemostatic efficiency,the levels of immune factors before and after treatment,and the rebleeding rate after treatment were compared between the two groups.Results After treatment,the effective rate of hemostasis in the early group was 98.00%,which was significantly higher than 82.61%in the conventional group,and the difference was statistically significant(χ^(2)=4.991,P=0.025).There was no statistically significant difference in the levels of CD3^(+),CD4^(+)and NK cells between the two groups before treatment(P>0.05).After treatment,the levels of CD3^(+),CD4^(+)and NK cells in the two groups were higher than those before treatment,which in the early group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the total rebleeding rate of the early group was 4.00%,which was lower than 21.74%of the conventional group,and the difference was statistically significant(χ^(2)=6.892,P=0.008).Conclusion Endoscopic titanium clip occlusion in patients with NVUGIB within 6-<12 hours after admission can effectively improve the hemostatic efficiency of NVUGIB,improve the immune function of patients,reduce the incidence of rebleeding,and improve the prognosis of patients.

关 键 词：非静脉曲张性上消化道出血 内镜 钛夹封闭时间 止血 再出血 

分 类 号：R573.2[医药卫生—消化系统]