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目的探讨综合治疗急性非静脉曲张性上消化道大出血的疗效。方法回顾性分析安庆医院2010年5月至2011年4月50例急性非静脉曲张性上消化道大出血患者的临床资料。结果 33例联合使用奥曲肽和质子泵抑制剂止血成功,4例胃溃疡伴有渗血者分别予3～8枚金属钛夹止血成功,3例胃溃疡,2例球部溃疡,Mallory-Weiss综合征、Dieulafoy溃疡、Mallory-Weiss综合征合并胃溃疡各1例伴有活动性出血者均急转外科手术治疗成功。Dieulafoy溃疡、残胃吻合口溃疡、球部溃疡伴活动性出血者各1例转外科后拒绝手术自动出院,2例胃癌转外科手术,总有效率为94%,住院时间3～36 d,平均11.4 d。结论联合使用奥曲肽及质子泵抑制剂,必要时金属钛夹治疗急性非静脉曲张性上消化道大出血疗效良好。
Objective To investigate the curative effect of comprehensive treatment of acute non-variceal upper gastrointestinal hemorrhage. Methods The clinical data of 50 patients with acute non-variceal upper gastrointestinal bleeding in Anqing Hospital from May 2010 to April 2011 were retrospectively analyzed. Results 33 cases of combined octreotide and proton pump inhibitor hemostasis was successful, 4 cases of gastric ulcer accompanied by bleeding were 3 to 8 pieces of titanium clip to stop bleeding, 3 cases of gastric ulcer, 2 cases of ulcer, Mallory-Weiss comprehensive Signs, Dieulafoy ulcers, Mallory-Weiss syndrome with gastric ulcer in 1 case with active bleeding were acute surgical treatment success. Dieulafoy ulcers, gastric stump anastomotic ulcer, ulceration with active ulcer in each of the 1 case of surgery after surgery refused to surgically discharged, 2 cases of gastric cancer surgery, the total effective rate was 94%, hospital stay 3 ~ 36 d, the average 11.4 d. Conclusion Combined use of octreotide and proton pump inhibitors, if necessary, titanium clip treatment of acute non-variceal upper gastrointestinal bleeding with good effect.