内镜下金属钛夹联合垂体后叶素治疗上消化道出血的效果观察  

Effect of endoscopic titanium clamp combined with pituitrin on upper gastrointestinal bleeding

作　　者：屈冰[1] 丁清清[1] 徐鹏[1] 张麒[1] Qu Bing;Ding Qingqing;Xu Peng;Zhang Qi(Ward I,Department of Gastrointestinal Surgery,Hernia and Abdominal Wall Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院胃肠外科一病区(疝和腹壁外科),郑州450000

出　　处：《中国实用医刊》2024年第9期17-20,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨内镜下金属钛夹止血联合垂体后叶素治疗上消化道出血(UGB)的临床效果。方法回顾性抽取2020年6月至2022年6月郑州大学第一附属医院收治的UGB患者114例,依据止血方案分为联合组(55例,给予内镜下金属钛夹联合垂体后叶素治疗)和对照组(59例,给予垂体后叶素治疗)。比较两组治疗3 d后临床疗效、康复情况、血清炎性因子[C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、白细胞介素-8(L-8)]水平、血小板功能[膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)及溶酶体膜糖蛋白CD62P、CD63]、住院期间并发症发生情况。结果治疗3 d后,联合组总有效率(96.36%,53/55)高于对照组(81.36%,48/59),P<0.05。联合组止血时间、症状消失时间、住院时间短于对照组(P<0.05)。治疗3 d后,联合组血清IL-1β、IL-8、CRP水平低于对照组,联合组GPⅡb/Ⅲa、CD62P、CD63高于对照组(P<0.05)。两组患者住院期间并发症总发生率比较,差异未见统计学意义(P>0.05)。结论内镜下金属钛夹止联合垂体后叶素治疗UGB效果明显,能减轻炎症反应,改善血小板功能,缩短止血时间,且安全性较高。Objective To investigate the clinical efficacy of endoscopic titanium clamp combined with pituitrin in the treatment of upper gastrointestinal hemorrhage(UGB).Methods A total of 114 patients with UGB admitted to the First Affiliated Hospital of Zhengzhou University from June 2020 to June 2022 were retrospectively selected.And they were divided into the combination group(55 cases,treated by endoscopic titanium clamp combined with pituitrin)and the control group(59 cases,treated with pituitrin)according to the hemostasis protocol.The clinical efficacy,recovery,levels of serum inflammatory factors,including C-reactive protein(CRP),interleukin-1β(IL-1β)and interleukin-8(IL-8),platelet function assessed by membrane glycoproteinⅡb/Ⅲa(GPⅡb/Ⅲa),CD62P of lysosomal membrane glycoprotein and CD63,and incidence of complications during hospitalization were compared between the two groups after 3 days of treatment.Results After 3 days of treatment,the total effective rate of the combination group(96.36%,53/55)was higher than that of the control group(81.36%,48/59),P<0.05.The hemostasis time,symptom disappearance time and hospital stay in the combination group were shorter than those in the control group(P<0.05).After 3 days of treatment,the serum levels of IL-1β,IL-8 and CRP in the combination group were lower than those in the control group,and the levels of GPⅡb/Ⅲa,CD62P and CD63 in the combination group were higher than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups during hospitalization(P>0.05).Conclusions Endoscopic titanium clamp combined with pituitrin is effective in the treatment of UGB,which can reduce inflammation,improve platelet function and shorten hemostasis time,with high safety.

关 键 词：消化道出血 金属钛夹 垂体后叶素 血小板功能 

分 类 号：R573.2[医药卫生—消化系统]