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目的:对热盛迫血型急性非静脉曲张性上消化道出血(ANVUGIB)患者进行内镜下喷洒生肌止血散治疗,观察其止血疗效及临床安全性。方法:将60例热盛迫血型ANVUGIB患者随机分为2组各30例,2组患者术前均予西医常规治疗,待生命体征平稳后,于出血24h内,治疗组予胃镜下喷洒生肌止血散,对照组喷洒重酒石酸去甲肾上腺素注射液,内镜下治疗后2组均继续采用西医常规治疗方案。对2组治疗后的即时止血率、再出血率、大便潜血转阴率、平均止血时间、平均住院时间、总有效率等数据进行记录比较。结果:治疗组总有效率为96.67%,显著高于对照组的83.33%;即时止血率为96.67%,优于对照组的76.67%;再出血率为3.33%,显著低于对照组的20.00%;大便潜血转阴率为90.00%,明显高于对照组的60.00%;平均止血时间为(31.43±7.67)h,显著短于对照组的(44.20±17.15)h;平均住院时间为(6.40±1.43)d,明显短于对照组的(7.27±1.68)d;2组各项指标差异均有统计学意义(P<0.05)。治疗组未出现不良反应。结论:内镜下喷洒生肌止血散治疗热盛迫血型ANVUGIB,能迅速止血,提高止血率、大便转阴率及治疗的总有效率,并可缩短止血时间及住院时间,且安全性高。
OBJECTIVE: To treat patients with acute non-variceal upper gastrointestinal hemorrhage (ANVUGIB) who suffer from acute exacerbation of blood type by endoscopically administering Shengji Zhigan San to observe their hemostatic efficacy and clinical safety. Methods: Sixty patients with ANVUGIB were randomly divided into two groups (n = 30 in each group). The patients in both groups were given routine western medicine before the operation. After the vital signs were stable, the patients in the treatment group were treated with gastroscope Hemostatic San, the control group norepinephrine tartrate injection, endoscopic treatment after 2 groups were continued to use Western conventional treatment. The data of immediate hemostatic rate, rebleeding rate, fecal occult blood negative rate, mean hemostasis time, average length of hospital stay, and total effective rate were recorded and compared in two groups after treatment. Results: The total effective rate of the treatment group was 96.67%, significantly higher than that of the control group (83.33%); immediate hemostasis rate was 96.67%, which was better than 76.67% of the control group; the rate of rebleeding was 3.33%, significantly lower than that of the control group (20.00% ; The fecal occult blood negative rate was 90.00%, significantly higher than that of the control group (60.00%); the mean hemostasis time was (31.43 ± 7.67) h, significantly shorter than that of the control group (44.20 ± 17.15) h; the average length of hospital stay was (6.40 ± 1.43) d, which was significantly shorter than that of the control group (7.27 ± 1.68) d. There was significant difference between the two groups (P <0.05). The treatment group did not appear adverse reactions. Conclusions: Endoscopic injection of myogenic hemostatic powder for the treatment of exuberant blood type ANVUGIB can quickly stop bleeding, improve hemostatic rate, defecation rate and the total effective rate of treatment, and can shorten the time to stop bleeding and hospitalization, and high safety.