静脉消化道出血内镜下大剂量去甲肾上腺素靶控注射联合氩.PDFVIP

内镜下大剂量去甲肾上腺素靶控注射联合氩离子凝固术治疗老年非 静脉消化道出血* 钱　燎 （湖北武汉市武东医院内科 武汉 430084 ） 摘要 目的：研究内镜下大剂量去甲肾上腺素靶控注射联合氩离子凝固术治疗老年非 静脉消化道出血的临床效果。方法：选择2013年5月至2014年9月湖北武汉市武 东医院内科收治的非静脉消化道出血患者46例为研究对象，接受内镜治疗并随 机分为两组，观察组接受内镜下大剂量甲肾上腺素靶控注射联合氩离子凝固术 ，对照组患者接受内镜下氩离子凝固术，比较两组患者的止血效果及应激反应 程度。结果：观察组患者止血时间、出血量、输血量、再出血率均明显低于对 照组（均 P0.05 ）；观察组皮质醇（ Cor ）、肾上腺素( E)、去甲肾上腺素(NE)水平均明显低于对照组（均P0.05 ）。结论：内镜下大 剂量甲肾上腺素靶控注射联合氩离子凝固术治疗非静脉消化道出血，能够改善 止血效果，缓解应激反应，是治疗老年非静脉消化道出血较为理想的内镜方式 。 关键词 非静脉消化道出血；氩离子凝固术；去甲肾上腺素；应激反应 中图分类号：Ｒ　文献标志码：Ａ　文章编号： *基金项目 ：湖北省科研基金资助项目(No.JX6811 ） 收稿日期：2016－03－16 Endoscopic high-dose norepinephrine target-controlled injection combined with argon plasma coagulation in the treatment of elderly non-vein gastrointestinal hemorrhage Qian Liao.(Department of internal Medicine, Hubei Wuhan Wudong Hospital, Wuhan 430084,China ) Abstract: Objective: To study the effect of endoscopic high-dose norepinephrine target- controlled injection combined with argon plasma coagulation in the treatment of elderly non-vein gastrointestinal hemorrhage. Methods: 46 cases of elderly non-vein gastrointestinal hemorrhage patients in our hospital from May 2013 to September 2014 were enrolled and given endoscopic treatment, randomly divided into two groups. The observation group received endoscopic high- dose epinephrine target-controlled injection combined with argon plasma coagulation, control group patients received argon plasma coagulation. Then hemostatic effect and stress response degree of two groups compared. Results: Hemostatic effect: observation group patients bleeding time, blood loss volume , blood transfusion amount, rebleeding rate were significantly lower than 2 the control group （t/x =6.968~11.970, P0.05 ）; Stress response: observation group Cor, E, NE levels were