论文部分内容阅读
目的 :探讨内镜下局部注射对不同内镜征象溃疡病出血患者的治疗效果。方法 :按Forrest分级选择急诊内镜诊断为消化性溃疡伴活动性出血或伴有“可见血管残端”近期出血迹象病例 ,分为 3组 :喷血 (Ⅰa)组、渗血 (Ⅰb)组和血管残端 (Ⅱa)组。 10 2例患者均接受内镜下局部注射治疗 ,反复大出血者外科手术。结果 :内镜下局部注射的即刻止血率Ⅰa组 91% ,Ⅰb组、Ⅱa组均为 10 0 %。 3种不同内镜征象患者治疗后的再出血率为Ⅰa组 2 1 7% ,Ⅰb组 4 9% ,Ⅱa组 5 6 % ,差异有统计学意义 (P <0 0 5 )。急诊手术率为 3 3%～ 8 7% ,各组之间手术率差异无显著性意义。结论 :内镜下局部注射治疗溃疡病出血的即时止血效果好 ,Ⅰa组再出血的发生率较Ⅰb组、Ⅱa组高 ,经内镜成功治疗的患者急诊手术率与内镜征象无关
Objective: To investigate the effect of local injection on endoscopic bleeding in patients with different endoscopic signs of ulcer disease. Methods: According to the Forrest classification, emergency endoscopy was used to diagnose the peptic ulcer associated with active bleeding or the recent signs of “visible vascular stump” hemorrhage. The patients were divided into three groups: splenic blood (Ⅰa) group, Ⅰb And vascular stump (IIa) group. 10 2 patients underwent endoscopic endoscopic injections and repeated haemorrhage surgery. Results: The immediate rate of endarterectomy was 91% in group Ⅰa and 100% in group Ⅰb and group Ⅱa. The rebleeding rate of the three kinds of patients with endoscopic signs after treatment was 21.7% in group Ⅰa, 49% in group Ⅰb and 56% in group Ⅱa, with significant difference (P <0.05). The emergency operation rate was 33% ~ 87%, there was no significant difference in the operative rate among the groups. Conclusions: The immediate hemostatic effect of local injection for the treatment of ulcer hemorrhage under endoscopy is good. The incidence of rebleeding in group Ⅰa is higher than that of group Ⅰb and Ⅱa. The rate of emergency operation in patients undergoing endoscopic treatment is not related to the signs of endoscopy