胃镜治疗急性非静脉曲张上消化道出血不同方法的-第三军医大学学报.DOCVIP

胃镜下不同方法治疗急性非静脉曲张上消化道出血的疗效分析 樊超强，王 雷，李宜辉 ，任 玮，郭红，张霞 ，赵国策，赵晓晏*（第三军医大学新桥医院消化内科，重庆400037） 摘要：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级非静脉曲张上消化道出血的疗效Rockall再出血评分对于内镜下止血疗效的影响。方法：经胃镜确诊为ForrestⅠ级和Ⅱa级上消化道出血，钛夹、注射联合钛夹和注射联合氩气刀对出血灶进行治疗，并进行Rockall评分，比较3种治疗方法不同Rockall评分的患者疗效差异。结果：注射联合钛夹组止血率9.92%和注射联合氩气刀组止血率9.18%，均高于钛夹组止血率84.62%（P＜0.0）Rockall评分＜2分的病例钛夹治疗止血率为100%；34分的注射联合钛夹和注射联合氩气刀组止血率相同，都为100%，和单纯钛夹组止血率（92.31%）比较无差异；5分的注射联合氩气刀组止血率（.45%）和注射联合钛夹组的止血率.30%）无明显差异，钛夹组止血率（75%）（P＜0.0）。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优于单纯钛夹治疗；Rockall关键词：出血；胃镜；止血 Observation on the curative effects of different endoscopic methods in treatment of acute norvariceal upper gastrointestinal hemorrhage （ANVUGIB）. Fan Chao-qiang,Wang Lei,Li Yi-hui,Ren Wei,Guo Hong,Zhang Xiao,Zhao Guo-ce,Zhao Xiao-yan（Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chong qing 40037, China）Abstract： Objective To evaluate the curative effects of clips, injection with clips and injection with argon plasma coagulation (APC) ,the effect of endoscopic hemostasis in different ForrestⅠ and Ⅱa grade-level. Methods The endoscopy confirmed Forrest Ⅰ and Ⅱa grade-level and ANVUGIB of 182 cases, respectively, with clips（78cases）, injection with clips(49cases) and injection with APC (55cases) for treatment of bleeding, and Rockall score to compare three methods to haemostatic rate and the effect of different Rockall score in the patients. Results The haemostatic rate in the group of injection with clips and group of injection with APC were 95.92% and 98.18% respectively, they were higher than the rate of clips (84.62%)（P1＜0.0）. The haemostatic rate in clip which Rockall risk score was lower than 2 was 100% , but when Rockall risk score was 3-4, there were no difference of haemostatic rate between the groups of injection with clip and injection with APC (both of them were100%) and the clips (92.31%). When Rockall risk score was higher than 5, there were no difference of haemostatic rate between