不同内镜止血方法治疗老年消化性溃疡出血效果比较.docVIP

不同内镜止血方法治疗老年消化性溃疡出血效果比较 　　[摘要] 目的 评价不同内镜止血方法治疗老年消化性溃疡出血的效果。 方法 回顾性分析2008年1月～2013年12月在北京大学首钢医院住院并接受内镜治疗的80例老年消化性溃疡出血患者的临床及内镜检查资料，病变出血征象采用Forrest分级。内镜止血治疗方法包括内镜下肾上腺素注射（54例）和金属钛夹治疗（26例）。 结果 进行内镜治疗的病变均为Forrest Ⅰa～Ⅱb级。与内镜下肾上腺素注射组相比，金属钛夹治疗组的内镜治疗成功率更高（96.2%与87.0%），再出血发生率更低（7.7%与14.8%），临床症状消失时间更短[（2.3±0.6）d与（3.4±1.1）d]，住院天数更短[（7.8±0.9）d与（11.5±2.4）d]，差异均有统计学意义。 结论 内镜下金属钛夹止血治疗老年消化性溃疡出血的有效性和安全性均优于肾上腺素注射治疗。 　　[关键词] 胃肠出血；止血；内窥镜 　　[中图分类号] R573.1 [文献标识码] B [文章编号] 2095-0616（2014）16-208-03 　　Effect of different endoscopic hemostasis in elder patients with peptic ulcer bleeding 　　WANG Zhilan JIA Shujuan CHEN Junhong 　　Department of Gastroenterology， Peking University Shougang Hospital， Beijing 100044， China 　　[Abstract] Objective To evaluate the clinical value of different endoscopic hemostasis in elder patients with peptic ulcer bleeding.Methods Eighty elder patients with peptic ulcer bleeding were diagnosed in Peking University Shougang Hospital from January 2008 to December 2013. The clinical and endoscopic data of these patients was analyzed retrospectively. Stigmata of recent hemorrhage was evaluated by Forrest classification. Different endoscopic treatment therapy was administrated， including epinephrine injection （n=54） and metal titanium clamp （n=26）. Results Hemorrhagic lesions of Forrest Ⅰa-Ⅱb were selected for endoscopic treatment. Compared to group treated with epinephrine injection， group treated with metal titanium clamp had higher effective rates （96.2% Vs. 87.0%）， lower rehemorrgagic rates （7.7% Vs. 14.8%）， shorter time to symptoms disappearance [（2.3±0.6） days Vs. （3.4±1.1） days]， and shorter hospitalization time [（7.8±0.9） days Vs. （11.5±2.4） days].Conclusion The efficiency and safety of endoscopic metal titanium clamp therapy is better than epinephrine injection hemostatic on the treatment of elder patients with peptic ulcer bleeding. 　　[Keywords] Gastrointestinal hemorrhage； Hemostasis； Endoscopic 　　急性非静脉曲张性上消化道出血是指Treitz韧带以上消化道的非静脉曲张性疾病引起的出血，以消化性溃疡最为常见。急性上消化道出血通