摘要
目的评价胃镜下钛夹、注射联合钛夹和注射联合氩气刀治疗ForrestⅠ级和Ⅱa级急性非静脉曲张上消化道出血的疗效,以及不同Rockall再出血评分的内镜下止血疗效的差异。方法经胃镜确诊为ForrestⅠ级和Ⅱa级上消化道出血182例,随机分成钛夹组(78例)、注射联合钛夹组(49例)和注射联合氩气刀组(55例)对出血灶进行治疗,并进行Rockall评分,比较3种治疗方法的止血率和不同Rockall评分的患者疗效差异。结果注射联合钛夹组止血率95.92%和注射联合氩气刀组止血率98.18%,均高于钛夹组止血率84.62%(P<0.05);Rockall评分<2分的病例钛夹治疗止血率为100%;3～4分的注射联合钛夹和注射联合氩气刀2组止血率相同,都为100%,和单纯钛夹组止血率(92.31%)比较无统计学差异;≥5分的注射联合氩气刀组止血率(95.45%)和注射联合钛夹组的止血率(96.30%)无明显差异,均明显高于钛夹组止血率(75%)(P<0.05)。结论胃镜下注射联合钛夹和注射联合氩气刀治疗ForrestⅠ级和Ⅱa级非静脉曲张上消化道出血疗效可靠,均优于单纯钛夹治疗;Rockall再出血严重程度对于止血疗效有直接影响。
Objective To evaluate the curative effect of gastroendoscopic titanium clips, injection with titanium clips, and injection with argon plasma coagulation （APC） for acute non-variceal upper gastrointestinal bleeding （ANVUGIB） （Forrest Ⅰ and Ⅱa ） and the effects of different Rockall scoring of rehemorrhage on endoscopic hemostasis. Methods A total of 182 cases of ANVUGIB of Forrest Ⅰ and Ⅱ aconfirmed gastroen-doscopically were randomly divided into group of titanium clips （78 cases） , group of injection combined with titanium clips （49 cases）, and injection with APC （55 cases） for treatment of bleeding. Rockall score was conducted to compare the hemostatic rate by the three methods and the effects of different Rockall scores on the curative effect in the patients were investigated. Results The hemostatic rates in the group of injection with titanium clips and the group of injection with APC were 95.92% and 98.18%, respectively, higher than that in the group of titanium clips （ 84.62% ） （P 〈 0.05 ）. The hemostatic rate in the group of titanium clips with Rockall risk score lower than 2 was 100%, but no difference was found in the hcmostatic rate between the groups of injection with titanium clips and injection with APC （both of them were 100% ） and the group of titanium clips （92.31%） when Rockall risk score was 3 -4. When Rockall risk score was higher than 5, there were no difference in hemostatic rate between the group of injection with APC （95.45%） and the group of injection with titanium clips （96.30%）, but it was higher than that in the group of titanium clips （75%） （P 〈0.05）. Conclusion The curative effect of injection with titanium clips and injection with APC are reliable, and are superior to the treatment with titanium clips alone. The hemostatic rate is correlated with Rockall risk score.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2009年第13期1312-1314,共3页
Journal of Third Military Medical University
关键词
出血
胃镜
止血
hemorrhage
endoscopy
hemostasis
