胃肠镜下氩离子凝固术在胃十二指肠出血的临床治疗效果及并发症研究  

Study on the clinically therapeutic effect and complications of APC under gastrointestinal endoscope in gastroduodenal bleeding

作　　者：王雪艳 王丹丹 蔡习强 Wang Xueyan;Wang Dandan;Cai Xiqiang(Department of Gastroenterology,Second Affiliated Hospital of Air Force Medical University,Xi'an 710000,China)

机构地区：[1]空军军医大学第二附属医院消化内科,西安710000

出　　处：《中国医学装备》2025年第1期72-75,81,共5页China Medical Equipment

基　　金：陕西省自然青年科学基金(HK20220741)。

摘　　要：目的:探讨胃肠镜下氩离子凝固术(APC)在胃十二指肠出血的临床疗效及并发症。方法:选取2021年1月至2023年12月唐都医院收治的206例胃十二指肠出血患者,按就诊挂号的单双号将其分为对照组和观察组,每组103例,对照组接受胃肠镜下注射止血术治疗,观察组接受胃肠镜下APC治疗,比较两组手术疗效,应激反应指标水平,以及并发症发生情况。结果:治疗疗效显示,观察组103例患者中显效56例,有效42例,无效5例,治疗总有效率为95.15%;对照组103例患者中显效35例,有效49例,无效19例,治疗总有效率为81.55%。两组比较差异有统计学意义(χ^(2)=9.244,P<0.05)。观察组术中出血量和输血量分别为(375.84±59.88)、(417.62±49.85)ml均低于对照组,止血时间和住院时间分别为(1.79±0.26)、(5.14±0.43)d均短于对照组,两组比较差异有统计学意义(t=16.668、38.022、26.405、29.073,P<0.05)。术后1 d两组应激反应指标均降低,且观察组皮质醇(Cor)、丙二醛(MDA)、去甲肾上腺素(NE)及肾上腺素(E)水平低于对照组,两组比较差异有统计学意义(t=20.777、68.462、13.510、14.791,P<0.05)。观察组并发症发生率为5.83%,低于对照组的15.53%,两组比较差异有统计学意义(χ^(2)=5.089,P<0.05)。结论:胃肠镜下APC可提高胃十二指肠出血治疗效果,减轻应激反应,减少并发症的出现。Objective:To explore clinically therapeutic effect and complications of argon plasma coagulation(APC)under gastrointestinal endoscope in gastroduodenal bleeding.Methods:A total of 206 patients with gastroduodenal bleeding who admitted to Tangdu Hospital from January 2021 to December 2023 were selected,and they were divided into control group and observation group according to the single and double numbers of outpatient registration,with 103 cases in each group.The control group was treated with injection hemostasis under gastrointestinal endoscope,and the observation group was treated with APC treatment under gastrointestinal endoscope.The surgical efficacies,the levels of stress reaction indicators and incidences of complication between two groups were compared.Results:In 103 cases of observation group,56 cases occurred significant effect,and 42 cases were valid,and 5 cases were invalid,and the total efficiency rate of treatment was 95.15%.In 103 cases of control group,35 cases occurred significant effect,and 49 cases were valid,and 19 cases were invalid,and the total efficiency rate of treatment was 81.55%,and the difference was significant(χ^(2)=9.244,P<0.05).The intraoperative bleeding and blood transfusion volume of observation group were lower than those of control group,and hemostasis time and hospitalization time of observation group were shorter than those of control group,and the differences of them were significant(t=16.668,38.022,26.405,29.073,P<0.05),respectively.After 1d of surgery,the stress reaction indicators of the two groups reduced,and the levels of cortisol(Cor),malondialdehyde(MDA),norepinephrine(NE)and adrenaline(E)of observation group were lower than those of control group(t=20.777,68.462,13.510,14.791,P<0.05),respectively.The incidence of the complications of observation group were 5.83%,which was significantly lower than that(15.53%)of control group(χ^(2)=5.089,P<0.05).Conclusion:Gastrointestinal endoscopic APC can improve the therapeutic effect of gastroduodenal bleeding,and alleviate

关 键 词：胃十二指肠出血 胃肠镜 氩离子凝固术(APC) 疗效 应激反应 并发症 

分 类 号：R573.1[医药卫生—消化系统]