消化内镜联合四联疗法治疗胃溃疡出血的临床疗效及再出血的因素被引量：20

Clinical effect of digestive endoscopy combined with quadruple therapy in treatment of gastric ulcer bleeding and rebleeding

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摘要目的：探讨消化内镜联合四联疗法治疗胃溃疡出血的临床疗效及再出血的因素。方法选取2012年5月--2014年5月来我院救治的胃溃疡出血患者80例，按照随机数字分为研究组及对照组各40例。对两组患者的临床疗效，Hp根除标准，再出血的单因素及多因素进行比较。结果研究组的总有效率为92.5%，对照组为80.0%，两组比较差异有统计学意义（P＜0.05）。连续两次尿素呼气试验阴性确定Hp根除，观察组清除38例，清除率为95.0%；对照组清除33例，清除率为82.5%，两组比较，差异有统计学意义（χ2=7.654， P＜0.05）。影响再出血的因素的单因素中，A、B两组的年龄、性别比比较，差异无统计学意义（P＞0.05）， A组溃疡A1期人数百分比及出血量远远大于B组（P均＜0.05），A组血红蛋白血小板、是否内镜治疗人数百分比均小于B组（P＜0.05）。影响再出血的多因素危险因素主要包括内镜治疗，血红蛋白低，溃疡A1期。结论内镜合并四联疗法治疗胃溃疡出血效果好，再出血的危险因素包括内镜治疗，血红蛋白低，溃疡A1期。 Objective To explore the clinical effect of digestive endoscopy combined with quadruple therapy in treatment of gastric ulcer bleeding and rebleeding. Methods 80 cases of patients with gastric ulcer hemorrhage from May 2012 to May 2014 in our hospital were randomly divided into study group and control group with 40 cases in each. The clinical effects of two groups were compared, eradication of the Hp standard, single factor and multi factors of rebleeding. Results The total efficiency rate of research group was 92.5%, significantly higher than that of the control group 80.0%, there were significant differences between the two groups（P 〈 0.05）. Two consecutive urea breath test negative determine theeradication of the Hp, observation of 38 cases of clearance, clearance rate was 95.0%;the control group of 33 cases of clearance, clearance rate was 82.5%, comparing the two groups had significant difference （x2 =7.654, P 〈 0.05）. Single factor influencing factors of rebleeding in A, B two groups in age, sex ratio, the difference was not significant（P 〉 0.05）, A group the amount of bleeding, ulcer stage A1 percentage was higher than B group（P 〈 0.05）, group A hemoglobin platelet, whether endoscopic treatment were small percentage in group B（P 〈 0.05）. Many factors affect the re bleeding, endoscopic therapy, lower hemoglobin, ulcer stage A1 were risk factors of rebleeding. Conclusion Endoscopy combined with quadruple therapy in treatment of gastric ulcerbleeding, rebleeding risk factors including endoscopic therapy, lower hemoglobin, ulcer stage A1.