摘要
目的探讨胃镜下注射肾上腺素联合钛夹治疗急性非静脉曲张性上消化道出血的临床效果,分析其可能的作用机制。方法选择2015年1月至2015年12月收治的急性非静脉曲张性上消化道出血患者92例作为研究对象,采用随机数字表法分为观察组和对照组,每组各46例。对照组给予胃镜下金属钛夹夹闭治疗,观察组给予胃镜下注射肾上腺素(距出血灶3~5 mm处)联合钛夹治疗,比较两组的止血效果、血清内毒素(LPS)和C反应蛋白(CRP)表达水平以及不良反应情况。结果治疗3 d后,观察组血清LPS、CRP表达水平明显低于对照组,差异具有统计学意义(P<0.01);治疗1周内,观察组再出血率(2.17%)明显低于对照组(15.22%),差异具有统计学意义(P<0.05);观察组穿孔、感染、发热、周围循环衰竭等发生率均明显低于对照组,差异均具有统计学意义(P均<0.05)。结论胃镜下注射肾上腺素联合钛夹治疗有助于提高急性非静脉曲张性上消化道出血患者的止血效果,减少不良反应,这可能与降低血清LPS和CRP的表达水平有关。
Objective This paper aims to investigate the hemostatic effect of endoscopic injection of epinephrine combined with titanium clips on patients with acute non-variceal upper gastrointestinal bleeding,and to analyze its possible mechanism.Methods Ninety two cases of acute non-variceal upper gastrointestinal bleeding patients from January 2015 to December 2015 were selected as the research object who were randomly divided into the observation group and the control group with46 cases in each group.The control group was given endoscopic metal titanium clamp treatment,while the observation group were given epinephrine injection under gastroscope（3~5 mm around the bleeding focus）combined with titanium clip treatment.The hemostatic effect,serum LPS and CRP content and adverse reaction of the two groups were compared.Results After the 3 d treatment,the serum LPS and CRP of the observation group were significantly lower than those of the control group（P〈0.01）;within1 week of treatment,the rebleeding rate（which is 2.17%）of the observation group was significantly lower than that of the control group（which is 15.22%）（P〈0.05）;the perforation,infection,fever,and peripheral circulatory failure incidence of the observation group were significantly lower than those of the control group（P〈0.05）.Conclusions Epinephrine injection combined with titanium clips endoscopic treatment is helpful to improve the hemostatic effect of acute non-variceal upper digestive tract hemorrhage patients,and to reduce adverse reactions.The factors may be related to the decrease of serum endotoxin and C reactive protein level.
出处
《国际消化病杂志》
CAS
2017年第6期392-395,共4页
International Journal of Digestive Diseases
关键词
急性非静脉曲张性上消化道出血
金属钛夹
肾上腺素
炎性因子
Acute non-variceal upper gastrointestinal bleeding
Titanium clamp
Epinephrine
Inflammatory factors
