内镜下金属夹治疗急性上消化道出血48例疗效观察.docVIP

内镜下金属夹治疗急性上消化道出血48例疗效观察 　　【摘要】目的:观察内镜下金属夹治疗急性上消化道出血的疗效。方法:收集我院2008年10月至2010年11月收治的95例上消化道出血患者,随机均分为治疗组及对照组。均行急诊胃镜检查确诊，并在内镜直视下明确出血部位，对照组47例给于基础治疗包括禁食，洗胃，补充血容量，必要时输血，同时给于静脉注射奥美拉唑60mg，2次/d，疗程1周。治疗组48例, 在此基础治疗上加于使用金属夹推送器对准出血部位两端,金属夹出血血管及附近组织,并用0.9%氯化钠注射液局部喷洒冲洗,确认完全止血。结果:治疗组显效30例，有效17例，无效1例，总有效率97.9%，对照组显效18例，有效21例，无效8例，总有效率83%，两组对比P 　　【关键词】内镜；金属夹；急性上消化道出血 　　Endoscopic metal clip in treatment of acute upper gastrointestinal bleeding clinical observation of 48 cases 　　【Abstract】Objective: to observe the endoscopic metal clip in the treatment of acute upper gastrointestinal bleeding curative effect. Methods: we collected from October 2008 November 2010 were 95 cases of patients with upper gastrointestinal bleeding, random are divided into the treatment group and control group. Were performed emergency gastroscope inspection in endoscopic diagnosis, and bleeding nasopharynx clear 47 patients to group based treatment included fasting, lavage, complement of blood transfusion, at the same time, when necessary, to intravenous ogilvy pull thiazole 60mg, 2 times a/d, course of 1 week. 48 cases in treatment group, and based on this, add to use metal treatment recommendation on the bleeding is clamping ends, metal clip bleeding vessels and surrounding tissue and 0.9% sodium chloride injection spray washing, confirm completely local bleeding.Results: 30 cases in treatment group and effectively got 17 cases, 1 case ineffective, the control group, the total effective rate 97.9%, respectively 18 cases, effective got 21 cases, invalid 8 cases failure; the total effective 83%, two groups of contrast P [1]Ia(喷射状?血)、Ib（活动性渗血）、IIa（裸露血管）入选本次观察，治疗组48例行钛夹治疗，其中男32例，女16例，年龄21～88岁，平均45岁。其中胃溃疡15例，十二指肠溃疡出血22例，Dieulafoy病出血2例，胃癌3例，食管喷门粘膜撕裂综合症6例。对照组47例，其中男33例，???14例，年龄20～87岁，平均44岁。其中胃溃疡16例，十二指肠溃疡出血22例，Dieulafoy病出血1例，胃癌3例，食管喷门粘膜撕裂综合症5例。两组年龄、性别、病变原因差异均无显著性（P0.05），具有可比性。 　　1.2 器械:Olympus GIF-XQ260电子胃镜，Olympus HX-5LR-1金属夹推送器及MAJ-459金属夹。 　　1.3 方法:基础治疗：禁食，洗胃，补充血容量，必要时输血，同时给于静脉注射奥美拉唑60mg，2次/d，疗程1周。治疗期间