内镜下不同止血方法治疗非静脉曲张性消化道出血效果.doc

内镜下不同止血方法治疗非静脉曲张性消化道出血的效果 　　[摘要] 目的 探讨内镜下不同止血方法治疗非静脉曲张性消化道出血的效果。 方法 回顾性分析2011年1月～2015年12月郑州市中医院收治的173例非静脉曲张性消化道出血患者的临床资料，根据患者的内镜下止血方式的不同，将患者分为四组：注射组54例患者给予1∶10 000肾上腺素止血，钛夹组39例采用血管夹止血，热凝组35例给予氩离子凝固止血，联合组45例给予1∶10 000肾上腺素联合氩离子凝固止血。观察各组出血原因分布情况；比较各组即刻止血率、再出血率及有效止血率。 结果 胃溃疡、十二指肠溃疡是非静脉曲张性消化道出血患者主要病因，其次是吻合口溃疡、贲门黏膜撕裂综合征、胃息肉出血、Dieulafoy病、胃癌、毛细血管扩张症、内镜下黏膜切除术术后、内镜下黏膜剥离术术后。注射组、热凝组及联合组均以胃溃疡及十二指肠溃疡最为常见，钛夹组以贲门黏膜撕裂综合征最为常见。各组即刻止血率比较，差异均无统计学意义（P 0.05）；联合组再出血率明显低于注射组、钛夹组、热凝组，而有效止血率高于其他各组，差异均有统计学意义（P 0.05）。 结论 内镜止血对于非静脉曲张性消化道出血患者具有较好的治疗效果，多种止血方法联合治疗对非静脉曲张性消化道出血止血效果更为明显，临床上应根据患者的病情合理选择止血方式 [关键词] 内镜；非静脉曲张性消化道出血；止血效果 [中图分类号] R573.2 [文献标识码] A [文章编号] 1673-7210（2016）07（b）-0128-04 [Abstract] Objective To explore the effect of different hemostatic method under endoscopic in the treatment of nonvarices gastrointestinal bleeding. Methods Clinical data of 173 patients with gastrointestinal bleeding from January 2011 to December 2011 in Hospital of Traditional Chinese Medicine of Zhengzhou City were analyzed retrospectively， and they were divided into four groups according to different hemostatic methods， 54 patients of injection group were given 1：10 000 Epinephrine， 39 patients of titanium clip group were given hemostatic method of titanium clip， 35 patients of thermosetting group were given argon ion coagulation hemostasis， and 45 patients of combination group were given 1∶10 000 Epinephrine combined with argon ion coagulation hemostasis. Hemorrhage causes of each group were observed； rate of immediately stop bleeding， bleeding again and stop bleeding effectively was compared. Results Gastric ulcer and duodenal ulcer were the leading cause of nonvarices gastrointestinal bleeding， and followed by anastomotic ulcer， Mallory-Weiss tear， gastric polyps bleeding， Dieulafoy disease， gastric carcinoma， telangiectasis， after EMR， after ESD； the leading cause of nonvarices gastrointestinal bleeding in the injection group， thermosetting group and combined group were gastric ulcer and duodenal