摘要
目的:探讨内镜下电凝与钛夹分别联合血凝酶注射治疗重症消化性溃疡出血疗效。方法:选取我院收治的86例重症消化性溃疡出血患者为受试对象,按照入院顺序随机分为电凝组与钛夹组各43例。电凝组患者予以血凝酶注射联合内镜下电凝止血,而钛夹组则予以血凝酶注射联合内镜下钛夹止血进行治疗。比较术前及术后3 d时,两组患者腹部疼痛程度[视觉模拟法疼痛评分量表(VAS)]、生长因子[血管内皮生长因子(VEGF)、表皮生长因子(EGF)]水平、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)]水平变化,分析两组患者止血效果、住院时间、术后3 d内并发症发生情况及术后3个月时溃疡愈合情况(畸田隆夫消化道溃疡分期法)差异。结果:术后3 d时,两组患者VAS评分、TNF-α、IL-10水平均较术前有显著下降(P均<0.05),但组间比较无统计学意义(P>0.05);两组患者VEGF、EGF水平均较术前有显著提升(P均<0.05),但组间比较均无统计学意义(P均>0.05)。两组患者止血成功率及住院时间比较均无统计学意义(P均>0.05)。术后3 d内,两组患者各项并发症发生率比较均无统计学意义(P均>0.05)。术后3个月时,两组患者溃疡愈合情况比较均无统计学意义(P均>0.05)。结论:内镜下电凝与钛夹分别联合血凝酶注射治疗重症消化性溃疡出血均可获得良好的止血效果,二者安全性均属良好,有利于患者预后恢复。
Objective: To investigate the therapeutic efficacy of electrocoagulation versus titanium clip placement respectively in combination with hemocoagulase injection in bleeding from severe peptic ulcer. Methods:Eighty-six patients with bleeding from severe peptic ulcer admitted to our hospital were included as subjects. Based on the timeline of admission,43 patients were randomly divided into the electrocoagulation group and the titanium clip group. For hemostasis,the electrocoagulation group received hemagglutinase injection and endoscopic electrocoagulation,while the titanium clip group received with hemagglutinase injection and endoscopic titanium clip placement. The two groups were compared for preoperative and postoperative 3-day abdominal pain [visual analogue pain scale( VAS) ],levels of growth factors( vascular endothelial growth factor( VEGF),epidermal growth factor( EGF) ]and inflammatory factors [tumor necrotizing factor-alpha( TNF-α),Interleukin-10( IL-10) ],hemostasis,length of hospital stay,postoperative 3-day complications,and 3-month ulcer healing( Yoshida Takao peptic ulcer staging method). Results: At 3 d after operation,the VAS scores,TNF-α,and IL-10 levels in the both groups were significantly lower than baseline( P < 0. 05),but there was no statistically significant difference between the two groups( P>0.05). The levels of VEGF and EGF in the two groups were significantly higher than baseline( P< 0.05),but there was no significant difference between the two groups( P > 0. 05). There were also no significant differences in the success rate of hemostasis and length of stay,postoperative 3-day complications,3-month ulcer healing between the two groups( all P>0.05). Conclusion: Endoscopic electrocoagulation and titanium clips used in combination with hemocoagulase injection in bleeding from severe peptic ulcer bleeding may achieve satisfactory hemostasis. The both treatment options offer good safety profile and are conducive to the patient outcome.
出处
《广州医科大学学报》
2018年第1期40-43,共4页
Academic Journal of Guangzhou Medical University
关键词
电凝
钛夹
血凝酶
消化性溃疡
出血
Electrocoagulation
Titanium clips
hemocoagulase
peptic ulcer
bleeding
