摘要
目的探讨多聚糖止血粉用于上消化道内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)中创面止血及预防术后再出血的临床效果。方法收集因上消化道黏膜病变需行ESD的67例住院患者为研究对象,其中,术中经常规创面处理后创面仍有渗血,使用多聚糖止血粉进行止血者32例;创面无明显渗血,使用凝血酶冻干粉预防再出血者35例。观察使用多聚糖止血粉的止血时间、止血成功率,并进行术后30 d随访,观察其安全性。同时,比较多聚糖止血粉组及凝血酶冻干粉组两组的术后再出血率。结果在使用多聚糖止血粉进行止血的32例患者中,术中用量为(1. 97±1. 04) g,止血时间为(83. 81±59. 94) s,止血成功率为96. 88%。患者术前及术后的血红蛋白、血小板计数、凝血酶原时间、INR、部分凝血活酶时间及凝血酶时间相比,差异均无统计学意义(P> 0. 05)。术后多聚糖止血粉组患者均未发生再出血,凝血酶冻干粉组有4例发生不同程度的再出血,差异有统计学意义(P <0. 05)。结论上消化道ESD中使用多聚糖止血粉效果显著、安全。与凝血酶冻干粉相比,可显著降低术后再出血风险。
ObjectiveTo investigate the clinical effect of polysaccharide hemospheres on hemostasis and preventing rehaemorrhagia in upper gastrointestinal endoscopic submucosal dissection （ESD）.MethodsSixty-seven hospitalized patients who underwent ESD for upper gastrointestinal tract mucosal lesions were selected. Among them,32 cases still had bleeding wounds after regular treatment, and they were treated with polysaccharide hemospheres. Thirty-five cases had clear wounds and used lyophilizing thrombin powder to prevent rehaemorrhagia. Time of hemostasis and the success rate of hemostasis were observed in polysaccharide hemospheres. After 30 days of follow-up, the safety was observed.ResultsIn the 32 patients treatment with polysaccharide hemospheres, the average dosage during operation was （1.97± 1.04）g, the average hemostasis time was （83.81±59.94）s, and the success rate of hemostasis was 96.88%. There were no significant differences in hemoglobin, platelet count, prothrombin time, INR, partial thromboplastin time and thrombin time in patients with preoperative and postoperative （ P〉0.05 ）. After the operation, no rehaemorrhagia was found in polysaccharide hemospheres group, but 4 cases of rehaemorrhagia were found in lyophilizing thrombin powder group, the difference was statistically significant （ P 〈0.05）.ConclusionThe effect of polysaccharide hemospheres in the ESD of upper gastrointestinal tract is significant and safe. Compared with lyophilizing thrombin powder, the risk of rehaemorrhagia is significantly reduced.
作者
丁慧
陈慧敏
赵韫嘉
张尧
李晓波
房静远
戈之铮
DING Hui;CHEN Huimin;ZHAO Yunjia;ZHANG Yao;LI Xiaobo;FANG Jingyuan;GE Zhizheng(Department of Gastroenterology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai Institute of Digestive Disease,Shanghai 200001,China)
出处
《胃肠病学和肝病学杂志》
CAS
2018年第10期1162-1166,共5页
Chinese Journal of Gastroenterology and Hepatology
关键词
多聚糖止血粉
内镜黏膜下剥离术
凝血酶冻干粉
上消化道
Polysaccharide hemospheres
Endoscopic submucosal dissection
Lyophilizing thrombin powder
Upper gastrointestinal tract
