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目的:探讨内镜下喷洒蛇毒血凝酶与金属钛夹治疗不明原因消化道出血的临床疗效。方法:选取2013年8月至2015年12月本院收治的不明原因消化道出血患者82例,随机分为对照组和实验组,每组41例。对照组给予内镜下喷洒蛇毒血凝酶治疗,实验组给予金属钛夹止血治疗。观察两组患者经止血治疗后即时止血时间、外科手术率、输血量、症状消失时间和临床疗效、再出血率和出血量。结果:实验组即时止血率明显高于对照组,输血量低于对照组(P<0.05);实验组呕血消失时间、潜血转阴时间和引流液变清时间均小于对照组(P<0.05);实验组痊愈率、总有效率高于对照组(P<0.05);两组之间再出血率和出血量比较差异无统计学意义(P>0.05)。结论:金属钛夹较内镜下喷洒蛇毒血凝酶对不明原因消化道出血具有更好的临床疗效,且再出血率较低。
Objective: To investigate the clinical efficacy of endoscopic spraying of venom hemagglutinin and metal titanium clip in the treatment of unexplained gastrointestinal bleeding. Methods: From August 2013 to December 2015, 82 patients with unexplained gastrointestinal bleeding admitted to our hospital were randomly divided into control group and experimental group, with 41 cases in each group. The control group was given endoscopic snake venom hemagglutinin treatment, the experimental group was treated with titanium clip to stop bleeding. The immediate bleeding time, surgical rate, blood transfusion, symptom disappearance time and clinical efficacy, rebleeding rate and bleeding volume were observed in two groups after hemostasis. Results: The rate of immediate hemostasis in the experimental group was significantly higher than that in the control group (P <0.05). The disappearance time of hematemesis, the time of occult blood transfusion and the time of clear fluid drainage in the experimental group were all less than those in the control group (P <0.05) The cure rate and total effective rate of the experimental group were higher than that of the control group (P <0.05). There was no significant difference between the two groups in the rate of hemorrhage and bleeding (P> 0.05). CONCLUSION: Titanium-titanium clips have a better clinical curative effect than vaginal endoscope-coating with venom hemagglutininase on unexplained gastrointestinal bleeding with a low rebleeding rate.