内镜下钛夹联合肾上腺素治疗非静脉曲张性上消化-第三军医大学学报.DOC

基金项目：云浮市医学科学技术计划项目（2013B74） 内镜下钛夹联合肾上腺素治疗非静脉曲张性上消化道出血临床观察 刘建华①、黎曙光①、阮国永①、梁爱霞①、邱桂梅① ①广东省新兴县人民医院 广东 新兴 527400 通信作者：刘建华 云浮市医学科学技术计划项目（2013B74） 【摘要】 目的:探讨内镜下钛夹联合注射肾上腺治疗非静脉曲张上消化道出血疗效。方法：将我院经胃镜检查确诊为非静脉曲张上消化道出血的患者120例，按统计学方法，随机分为钛夹治疗组，肾上腺素药物治疗组及钛夹联合注射肾上腺治疗组各40例，对比分析以上三种内镜下治疗方法的止血率及再出血率的差异。结果 三组即时止血率均为100％；钛夹组有7例发生再次出血，药物组有13例发生再出血，注射联合钛夹组中有1例发生再出血，再出血率分别为17.5％，32.5％，2.5％，三组差异有统计学意义(P0．05)。结论 胃镜下注射肾上腺素联合钛夹治疗非静脉曲张上消化道出血疗效可靠，优于单纯钛夹治疗。 【关键词】上消化道出血；金属钛夹；肾上腺素 Endoscopic titanium clips combined with epinephrine clinical observation on the treatment of non variceal hemorrhage of upper digestive tract 【Abstract】Objective: To study the endoscopic titanium clips combined injection of adrenal effect tract hemorrhage treatment of non variceal upper gastrointestinal. Methods: our hospital diagnosed by gastroscopy for non variceal upper digestive tract hemorrhage in 120 patients, according to the statistical method, were randomly divided into the treatment group of titanium clip, adrenergic drug treatment group and titanium clips combined injection of adrenal treatment group with 40 cases in each group, comparing the differences of above three kinds of endoscopic therapy hemostatic rate and the rate of rebleeding. The results of three groups of immediate hemostasis rate was 100%; titanium clip group 7 cases had re bleeding, 13 cases of rebleeding occurred in the drug group, injection combined with titanium clip group 1 cases had re bleeding, rebleeding rate were 17.5%, 32.5%, 2.5%, there was significant difference between three groups (P0.05). Conclusion endoscopic epinephrine injection combined with titanium clamp in the treatment of non variceal upper gastrointestinal hemorrhage curative effect is reliable, better than that of pure titanium clamp in the treatment of. [keyword] hemorrhage of upper digestive tract; titanium clip; epinephrine 非静脉曲张上消化道出血是消化内科常见的急症。而目前行急诊胃镜检查明确病因并内镜下治疗已成为治疗非静脉曲张上消化道出血的首选方法，而常用内镜下治疗有：1.药物喷洒及局部注射2.金属夹止血 3.高频电凝4.微波凝固5.结扎止血。而目前国内外对是否需要联合治疗及