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目的探讨急诊胃镜下注射治疗对消化性溃疡出血的临床价值。方法2004年1月~2008年12月因呕血和(或)黑便入院,经急诊内镜检查确诊为消化性溃疡出血患者236例,随机分成内科保守治疗和急诊内镜注射治疗两组,急诊内镜组在内科保守治疗的基础上于出血灶注射HLGE液。结果内镜组120例,止血有效率96.7%,再出血率3.3%,手术率1.7%,输血量(2.4±0.8)U,平均住院时间(3.6±0.9)d,平均住院费用(0.31±0.09)万元;内科保守治疗组116例,止血有效率77.6%,再出血率8.6%,手术率5.2%,输血量(5.3±0.9)U,平均住院时间(7.3±1.2)d,平均住院费用(0.54±0.13)万元,两组在上述指标比较均有显著性差异(P<0.05)。结论急诊胃镜下注射治疗消化性溃疡并出血简单有效,可降低再出血率、手术率,减少平均输血量,缩短住院时间,减少医疗费用,值得在临床上推广。
Objective To investigate the clinical value of emergency endoscopy in the treatment of peptic ulcer bleeding. Methods From January 2004 to December 2008, 236 patients with hemorrhagic peptic ulcer diagnosed by emergency endoscopy due to hematemesis and / or melena admitted to hospital were randomly divided into two groups: conservative treatment of internal medicine and emergency endoscopic injection, emergency treatment Endoscopic treatment group based on conservative treatment in the hemorrhage injection of HLGE fluid. Results In the endoscopic group, the effective rate of hemostasis was 96.7%, the rate of rebleeding was 3.3%, the rate of operation was 1.7%, the amount of blood transfusion (2.4 ± 0.8) U, the average length of hospital stay (3.6 ± 0.9) d, the average hospitalization cost (0.31 ± 0.09) ), And conservative treatment group (116 cases), the effective rate of hemostasis was 77.6%, the rate of rebleeding was 8.6%, the rate of operation was 5.2%, the amount of blood transfusion (5.3 ± 0.9) U, the average hospitalization time (7.3 ± 1.2) d, the average hospitalization cost (0.54 ± 0.13) million, the two groups in the above indicators were significantly different (P <0.05). Conclusion Emergency gastroscopic injection of peptic ulcer bleeding and simple and effective, can reduce the rate of rebleeding, operation rate, reduce the average blood transfusion, shorten the hospital stay, reduce medical costs, it is worth in the clinical promotion.