内镜吻合夹系统对不明原因消化道出血的应用价值研究  

Study on the Application Value of Endoscopic Anastomosis Clamp System for Gastrointestinal Bleeding Unknown Causes

作　　者：李秀蕾 朱云鹤 郭臣 Li Xiulei;Zhu Yunhe;Guo Chen(Endoscopy Center,Affiliated Hospital of Huanghe University of Science and Technology,Zhengzhou,Henan,450000,China)

机构地区：[1]黄河科技学院附属医院内镜中心,河南郑州450000 [2]郑州大学第二附属医院心血管外科,河南郑州450000

出　　处：《黑龙江医学》2024年第15期1828-1830,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨内镜吻合夹系统对不明原因消化道出血(OGIB)患者的诊断效能及治疗效果。方法:选取2021年1月—2022年6月黄河科技学院附属医院收治的136例消化道出血患者作为研究对象,将其中100例OGIB患者列为OGIB组,将其余36例病因明确的消化道出血患者列为对照组。应用软性内镜探查入组患者病灶情况,结合手术病理结果,验证软性内镜对不明原因消化道出血的诊断价值;对照组患者实施常规止血、OGIB组患者实施吻合夹系统(OTSC)治疗,比较两组患者的治疗效果。结果:与手术病理结果相比,软性内镜对OGIB的诊断准确率为86.76%(118/136)、敏感度为88.00%(88/100)、特异度为83.33%(30/36)。OGIB组患者止血成功率高于对照组,再出血率、转急诊率均低于对照组,差异有统计学意义(χ^(2)=7.919、13.317、18.934,P<0.05);OTSC组患者出血量、输血量、止血时间、住院时间均低于对照组,差异有统计学意义(t=4.483、12.872、44.587、4.888,P<0.05)。结论:应用软性内镜可实现对OGIB患者病情的有效诊断,以此为依据实施OTSC治疗可增强止血效果。Objective:To discuss the diagnostic efficacy and therapeutic effect of endoscopic anastomosis clamp system in patients with unexplained gastrointestinal bleeding(OGIB).Methods:136 patients with gastrointestinal bleeding admitted to the hospital from January 2021 to June 2022 were selected as the study subjects,including 100 patients with OGIB who were regarded as the OGIB group,and 36 patients with gastrointestinal bleeding whose etiology was clear were regarded as the control group.The soft endoscopy was used to explore the lesions of patients in the group through combining with surgical and pathological results to verify the its diagnostic value of unexplained gastrointestinal bleeding.Results:Compared with the surgical and pathological results,the diagnosis rate of accuracy of soft endoscopy for OGIB was 86.76%(118/136),the sensitivity was 88.00%(88/100),and the specificity was 83.33%(30/36).The success rate of hemostasis in the OGIB 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,with statistically significant difference(χ^(2)=7.919,13.317,18.934;P<0.05).The bleeding volume,blood transfusion volume,hemostasis time,hospitalization time and incidence of surgical related complications were lower than those in the control group.The differences were statistically significant(t=4.483,12.872,44.587,4.888;P<0.05).Conclusion:The application of soft endoscopy can achieve effective diagnosis of the condition of OGIB patients,and based on this,the implementation of OTSC treatment can enhance the hemostatic effect and reduce the risk of surgery.

关 键 词：内镜吻合夹系统 不明原因消化道出血 诊断价值 止血效果 手术并发症 

分 类 号：R573[医药卫生—消化系统]