内镜下治疗上消化道出血72例临床分析.docVIP

内镜下治疗上消化道出血72例临床分析 　　doi：10.3969/j.issn.1007-614x.2014.20.10 　　摘 要 目的：分析内镜诊疗对上消化道出血的临床疗效。方法：将上消化道出血患者72例随机分为对照组和内镜组各36例，对照组予以常规医药治疗，内镜组在对照组基础上采用内镜下药物注射、喷洒、金属钛夹等方法诊疗。结果：经治疗后，对照组止血总有效率77.78%，内镜组止血总有效率94.44%，内镜治疗组明显优于对照组（P0.05）；另内镜组转手术率、再次出血率明显低于对照组。结论：内镜诊疗对于上消化道出血疗效确切，风险小，值得临床推广。 　　关键词 内镜诊疗 上消化道出血 临床观察 　　Clinical analysis of 72 cases of upper gastrointestinal bleeding treated with endoscopic treatment 　　Zhang Youliang 　　The Peoples Hospital of Xin District，Guannan County，Jiangsu 222500 　　Abstract Objective：To explore the clinical curative effect of endoscopic treatment for upper gastrointestinal bleeding.Methods：72 cases of upper gastrointestinal bleeding were randomly divided into the control group and the endoscopic group with 36 cases in each group.The control group were treated with routine method.The endoscopic group were treated with endoscopic injection，spray，titanium clip and other treatment on the basis of the control group.Results：After treatment，in the control group，the total efficiency of hemostasis was 77.78%.In the endoscopic group，the total efficiency of hemostasis was 94.44%.The total efficiency of the control group was obviously better than that of endoscopic treatment group（P0.05）.In addition，the conversion operation rate，rebleeding rate of the endoscopic group were significantly lower than those of the control group.Conclusion：The clinical curative effect of endoscopic treatment for upper gastrointestinal bleeding is significant，and the risk is small，so it is worthy of clinical application. 　　Key words Endoscopic diagnosis and treatment；Upper gastrointestinal bleeding；Clinical observation 　　上消化道出血是内科临床常见危及生命的急症，急性大量出血是最主要的临床症状，病死率较高，多由溃疡、肿瘤、静脉曲张等原因引起。及时接诊并尽快给予综合、有效的医学诊疗，动态处理病情的变化进程，可有效地挽救患者的生命。随着近年来内镜诊疗技术的日臻完善及内镜技术在广大医院的普及，内镜诊疗已成为目前上消化道出血诊疗的首选方法[1]。2010年10月-2013年12月内镜诊疗上消化道出血患者72例，进行总结分析，现报告如下。 　　资料与方法 　　2011年10月-2013年12月收治上消化道出血患者72例，其中20例黑便，14例呕血，38例呕血伴黑便。按照随机原则分为内镜组和对照组。内镜组36例，男20例，女16例，年龄21.5～48.7岁，平均（31.45±10.55）岁；17例胃、食管静脉曲张，4例胃