消化内镜手术治疗胃十二指肠出血的应用效果以及对再出血率情况的影响研究  

Study on the Effect of Gastrointestinal Endoscopic Surgery in the Treatment of Gastroduodenal Bleeding and its Impact on the Rate of Rebleeding

作　　者：孙云霞 韩晓环 Sun Yunxia;Han Xiaohuan(Respiratory and Digestive Department,Jiaozuo Hospital,988 Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army,Jiaozuo,Henan,454001,China)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院焦作院区呼吸消化科,河南焦作454001 [2]中国人民解放军联勤保障部队第九八八医院焦作院区消化内科,河南焦作454001

出　　处：《黑龙江医学》2024年第14期1667-1669,1673,共4页Heilongjiang Medical Journal

基　　金：河南省医疗科技攻关项目(LHGJ2021003325)。

摘　　要：目的:观察消化内镜手术治疗胃十二指肠出血的效果及对患者再出血率情况的影响。方法:选取2021年1月—2022年6月中国人民解放军联勤保障部队第九八八医院焦作院区收治的128例胃十二指肠出血患者作为研究对象,通过抽签法将其分为对照组和观察组,每组各64例。对照组采用经内镜下注射治疗,观察组采用内镜下氩离子凝固术(APC)治疗。比较两组患者的治疗情况、临床指标及凝血功能改善情况,对所有患者开展为期半年随访,比较两组患者不良事件发生情况。结果:观察组止血成功率高于对照组,再出血率、转急诊率低于对照组,差异均有统计学意义(χ^(2)=4.167、9.191、7.603,P<0.05);观察组的出血量、输血量、止血时间、住院时间均低于对照组,差异均有统计学意义(t=2.904、13.177、28.447、6.951,P<0.05);治疗后,观察组的D-二聚体(D-D)、凝血酶原时间(PT)、凝血酶时间(TT)均低于对照组,差异均有统计学意义(t=10.349、5.327、4.220,P<0.05);随访期间,观察组的手术相关并发症发生率(7.81%)低于对照组(18.75%),差异均有统计学意义(χ^(2)=5.196,P<0.05)。结论:采用APC治疗胃十二指肠出血的止血效果显著,对降低患者再出血风险、改善凝血功能并降低手术相关并发症发生风险均有积极意义。Objective:To observe the effect of endoscopic surgery on gastroduodenal bleeding and its impact on the rate of rebleeding in patients.Methods:128 patients with gastroduodenal bleeding who were treated in the hospital from January 2021 to June 2022 were selected as the study subjects.The enrolled patients were randomly divided into two groups by lotting.Among them,64 patients in the control group were treated with endoscopic injection,and 64 patients in the observation group were treated with endoscopic APC.The treatment status,clinical indicators,and improvement of coagulation function of the two groups were compared.All patients were followed up for half a year to compare the incidence of adverse events between the two groups.Results:The success rate of hemostasis in the observation group was higher than that in the control group,the rebleeding rate and the conversion rate to emergency treatment were lower than those in the control group(χ^(2)=4.167,9.191,7.603;P<0.05).The bleeding volume,the blood transfusion volume,the hemostatic time and the hospital stay were lower than those in the control group(t=2.904,13.177,28.447,6.951;P<0.05).After treatment,the D-D,the PT and the TT were lower than those in the control group(t=10.349,5.327,4.220;P<0.05).The incidence of surgical related complications(7.81%)in the observation group was lower than that in the control group 18.75%(χ^(2)=5.196,P<0.05).Conclusion:Gastroduodenal bleeding can be significantly treated with APC,which has a positive significance in reducing the risk of rebleeding,improving blood coagulation,and reducing the risk of surgical related complications.

关 键 词：胃十二指肠出血 消化内镜氩离子凝固术 再出血率 凝血功能 并发症 

分 类 号：R573.2[医药卫生—消化系统]