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目的探讨消化性溃疡出血患者行急诊内镜下注射治疗与Forrest分级的关系,评估不同Forrest分级溃疡出血患者急诊内镜下注射治疗的必要性。方法选自2004年1月至2007年1月因呕血和(或)黑便入院,经急诊内镜检查确诊为溃疡性出血患者285例,溃疡出血按Forrest镜下表现分级,内镜注射止血治疗组145例,内科治疗组140例。结果内镜组145例,止血成功率95.9%,对照组140例,止血成功率80.0%,两组差异有统计学意义(P<0.05)。其中ForrestI级、Ⅱa级内镜组止血成功率(29/32、18/21)均高于对照组(13/28、12/19),Ⅱb级、Ⅱc级与Ⅲ级两组无明显差异。结论内镜注射止血治疗简单有效,优于单纯药物治疗,镜下表现为ForrestI级和Ⅱa级的溃疡出血患者,内镜下注射治疗是有效且必要的。
Objective To investigate the relationship between emergency endoscopic injection therapy and Forrest classification in patients with peptic ulcer bleeding and to evaluate the necessity of emergency endoscopic injections treatment in patients with Forrest’s classification of ulcer hemorrhage. Methods From January 2004 to January 2007, 285 patients were diagnosed as ulcer bleeding by emergency endoscopy because of hematemesis and / or melena admission. The ulcer bleeding was classified according to Forrest’s microscopic grade and endoscopic injection hemostasis Group 145 cases, 140 cases of medical treatment group. Results 145 cases of endoscopic group, hemostasis success rate was 95.9%, control group of 140 cases, hemostasis success rate was 80.0%, the difference between the two groups was statistically significant (P <0.05). The success rate of hemostasis (29/32, 18/21) in Forrest I and IIa groups was higher than that in control group (13/28 and 12/19), and there was no significant difference between IIb, IIc and III groups. Conclusion Endoscopic injection of hemostasis is simple and effective, which is superior to simple drug treatment. It is effective and necessary for endoscopic injection of Forrest class I and class IIa ulcer bleeding patients.