消化内镜治疗非静脉曲张性上消化道出血的临床研究

郑由周 王翠云 沈洁

[摘要] 目的 對消化内镜治疗非静脉曲张性上消化道出血的临床效果进行研究。 方法 采集2017年10月～2019年10月我院非静脉曲张性上消化道出血患者130例，对其实施常规止血治疗，治疗后有58例患者未成功止血，对此应采取内镜观察具体出血部位，寻找止血失败的原因，之后实施消化内镜止血治疗。比较不同治疗方法各项手术指标、生命体征及治疗有效率。 结果 常规止血组治疗有效率为55.4%，内镜止血组治疗有效率为94.8%;相较于常规止血组，内镜止血组治疗有效率更高，差异有统计学意义（P<0.05）。常规止血组再出血率13.8%，内镜止血组再出血率3.4%，相较于常规止血组，内镜止血组手术相关指标时间均更短，再出血率更低，差异有统计学意义（P<0.05）。两组治疗前各项生命体征差异无统计学意义（P>0.05）;相较于常规止血组，内镜止血组治疗后脉搏及休克指数更低，血红蛋白及收缩压更高，差异有统计学意义（P<0.05）。 结论 在非静脉曲张性上消化道出血治疗中，可通过消化内镜达到确切治疗效果，使患者恢复时间缩短，减少再出血情况，改善各项生命体征。

[关键词] 消化内镜;非静脉曲张性;上消化道出血;生命体征

[中图分类号] R573.2          [文献标识码] B          [文章编号] 1673-9701（2020）15-0049-03

The clinical study of digestive endoscopy in the treatment of non-variceal upper gastrointestinal bleeding

ZHENG Youzhou   WANG Cuiyun   SHEN Jie

Department of Gastroenterology， Mindong Hospital Affiliated to Fujian Medical University， Fu'an   355000， China

[Abstract] Objective To study the clinical effect of digestive endoscopy on non-variceal upper gastrointestinal bleeding. Methods 130 cases of non-variceal upper gastrointestinal bleeding in our hospital from October 2017 to October 2019 were collected. And they underwent conventional hemostatic treatment. After treatment， 58 patients did not successfully stop bleeding. Endoscopy should be used to observe the specific bleeding site and figure out the reason for the failure of hemostasis. Then digestive endoscopic hemostatic treatment was performed. The various surgical indicators， vital signs and treatment efficiency of different treatment methods were compared. Results The treatment effective rate of the endoscopic hemostatic group was 94.8%， which was higher than that of the conventional hemostatic group （55.4%）， with statistically significant difference（P<0.05）. The rebleeding rate in the conventional hemostatic group was 13.8%， and the rebleeding rate in the endoscopic hemostatic group was 3.4%. Compared with that of the conventional hemostatic group， the time for surgery-related indicators was shorter and the rebleeding rate was lower in the endoscopic hemostatic group， statistically significant difference（P<0.05）. The difference in vital signs before treatment between the two groups was not statistically significant（P>0.05）. Compared with that of the conventional hemostatic group， the pulse and shock indexes were lower， and hemoglobin and systolic blood pressure was higher in the endoscopic hemostatic group after treatment， and the difference was significant（P<0.05）. Conclusion In the treatment of non-variceal upper gastrointestinal bleeding， the digestive endoscopy can achieve exact treatment effect， which can shorten the recovery time of the patient， reduce the rebleeding situation， and improve various vital signs.

[Key words] Digestive endoscopy; Non-variceal; Upper gastrointestinal bleeding; Vital signs

在临床消化内科上，非静脉曲张性上消化道出血较为常见，临床症状主要表现为呕血、黑便，根据相关研究结果显示，恶性肿瘤、上消化道溃疡、胃黏膜病变等多种因素均可引发该疾病，由于致死率较高，因此需要尽早接受治疗，以保障患者生命安全[1-2]。目前临床上常规治疗方法应用广泛，虽具有一定效果，但无法达到预期，因此考虑更为有效方法治疗。而随着内镜技术的发展，消化内镜治疗开始受到广泛关注，并逐渐得到临床认可。本研究旨在探讨不同治疗方法对我院非静脉曲张性上消化道出血患者应用效果的差异性。现报道如下。

1 对象与方法