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纸质出版:2009
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樊超强,王雷,任玮,张霞,李宜辉,郭红,柏建鹰,赵国策,赵晓晏.胃镜下不同方法治疗急性非静脉曲张上消化道出血的疗效分析[J].陆军军医大学学报(原第三军医大学学报),2009,31(13):1312-1314.
FAN Chao-qiang,WANG Lei,REN Wei,ZHANG Xia,LI Yi-hui,GUO Hong,BAI Jian-ying,ZHAO Guo-ce,ZHAO Xiao-yan.Analysis of the curative effect of different gastroendoscopic methods for acute non-variceal upper gastrointestinal bleeding[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(13):1312-1314.
樊超强,王雷,任玮,张霞,李宜辉,郭红,柏建鹰,赵国策,赵晓晏.胃镜下不同方法治疗急性非静脉曲张上消化道出血的疗效分析[J].陆军军医大学学报(原第三军医大学学报),2009,31(13):1312-1314. DOI:
FAN Chao-qiang,WANG Lei,REN Wei,ZHANG Xia,LI Yi-hui,GUO Hong,BAI Jian-ying,ZHAO Guo-ce,ZHAO Xiao-yan.Analysis of the curative effect of different gastroendoscopic methods for acute non-variceal upper gastrointestinal bleeding[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(13):1312-1314. DOI:
目的 评价胃镜下钛夹、注射联合钛夹和注射联合氩气刀治疗ForrestⅠ级和Ⅱa级急性非静脉曲张上消化道出血的疗效,以及不同Rockall再出血评分的内镜下止血疗效的差异。 方法 经胃镜确诊为ForrestⅠ级和Ⅱa级上消化道出血182例,随机分成钛夹组(78例)、注射联合钛夹组(49例)和注射联合氩气刀组(55例)对出血灶进行治疗,并进行Rockall评分,比较3种治疗方法的止血率和不同Rockall评分的患者疗效差异。 结果 注射联合钛夹组止血率95.92%和注射联合氩气刀组止血率98.18%,均高于钛夹组止血率84.62%(P<0.05);Rockall评分<2分的病例钛夹治疗止血率为100%;3~4分的注射联合钛夹和注射联合氩气刀2组止血率相同,都为100%,和单纯钛夹组止血率(92.31%)比较无统计学差异;≥5分的注射联合氩气刀组止血率(95.45%)和注射联合钛夹组的止血率(96.30%)无明显差异,均明显高于钛夹组止血率(75%)(P<0.05)。 结论 胃镜下注射联合钛夹和注射联合氩气刀治疗ForrestⅠ级和Ⅱa级非静脉曲张上消化道出血疗效可靠,均优于单纯钛夹治疗;Rockall再出血严重程度对于止血疗效有直接影响。
Objective To evaluate the curative effect of gastroendoscopic titanium clips
injection with titanium clips
and injection with argon plasma coagulation (APC) for acute non-variceal upper gastrointestinal bleeding (ANVUGIB) (ForrestⅠ and Ⅱ
a
) and the effects of different Rockall scoring of rehemorrhage on endoscopic hemostasis. Methods A total of 182 cases of ANVUGIB of Forrest Ⅰ and Ⅱ
a
confirmed gastroendoscopically were randomly divided into group of titanium clips (78 cases)
group of injection combined with titanium clips (49 cases)
and injection with APC (55 cases) for treatment of bleeding. Rockall score was conducted to compare the hemostatic rate by the three methods and the effects of different Rockall scores on the curative effect in the patients were investigated. Results The hemostatic rates in the group of injection with titanium clips and the group of injection with APC were 95.92% and 98.18%
respectively
higher than that in the group of titanium clips (84.62%) (P0.05). The hemostatic rate in the group of titanium clips with Rockall risk score lower than 2 was 100%
but no difference was found in the hemostatic rate between the groups of injection with titanium clips and injection with APC (both of them were 100%) and the group of titanium clips (92.31%) when Rockall risk score was 3-4. When Rockall risk score was higher than 5
there were no difference in hemostatic rate between the group of injection with APC (95.45%) and the group of injection with titanium clips (96.30%)
but it was higher than that in the group of titanium clips (75%) (P0.05). Conclusion The curative effect of injection with titanium clips and injection with APC are reliable
and are superior to the treatment with titanium clips alone. The hemostatic rate is correlated with Rockall risk score.
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