内镜下金属止血夹联合肾上腺素注射治疗消化性溃疡出血的研究

目的 观察比较内镜下金属止血夹联合肾上腺素注射和内镜下单一肾上腺素注射治疗消化性溃疡出血的疗效及价值.方法 98例消化性溃疡出血患者随机分为A组和B组,其中A组48例,予内镜下金属止血夹联合肾上腺素注射治疗；B组50例,予内镜下单一肾上腺素注射治疗.结果 A组的有效止血率和出血停止率均为95.83％,但与B组比较差异无统计学意义（P＞0.05）.A组的再出血率（6.25％）较B组（22.00％）降低,差异有统计学意义（P＜0.05）,而在急诊手术率方面两组间（A组2.08％,B组8.00％）比较,差异无统计学意义（P＞0.05）；而对Forrest Ia的出血停止率,A组（88.89％）高于B组（40.00％）（P＜0.05）.结论 金属止血夹联合肾上腺素注射治疗可降低消化性溃疡出血的再出血率,改善止血效果,是一种安全有效的内镜下止血术.

The study of endoscopic hemostatic metal clip combined with Epinephrine injection in the treatment of peptic ulcer hemorrhage

Objective To compare the effect and clinical value of endoscopic hemostatic metal clip combined with Epinephrine injection and endoscopic Epinephrine injection in the treatment of peptic ulcer hemorrhage.Methods 98 patients with peptic ulcer hemorrhage were randomly divided into group A （48 cases） and group B （50 cases）.Group A was treated with endoscopic hemostatic metal clip combined with Epinephrine injection,while group B was only treated with endoscopic Epinephrine injection.Results The hemostatic rate and the stop bleeding rate in group A were both 95.83％,without significant differences compared with group B （P ＞ 0.05）.The rebleeding rate in group A was significantly lower than that in group B （6.25％ vs.22.00％,P ＜ 0.05）.The emergency operation rates in group A and group B were 2.08％ and 8.00％ separately,without significant difference between two groups （P ＞ 0.05）.The hemostasis rate for Forrest Ⅰ a in group A was significant higher than that in group B （88.89％ vs.40.00％,P ＜ 0.05）.Conclusion Endoscopic hemostatic metal clip combined with Epinephrine injection in the treatment of peptic ulcer hemorrhage can reduce rebleeding rate and improve hemostasis,which is a very safe and effective endoscopic hemostasis.