内镜注射治疗十二指肠溃疡出血失败的相关因素分析

目的：评价内镜注射治疗十二指肠溃疡出血患者的失败因素，方法：对132例有活动性出血或裸露出管的十二指肠溃疡出血患者进行内镜注射治疗，并从临床和内镜方面分析注射治疗失败的相关因素。结果：内镜注射治疗的有效止血率为83．3％（110／132），22例（16．7％），患者注射治疗失败，其中17例患者治疗后继续出血或再出血，5例因出血部位难接近而失败。内镜治疗失败与患者休克表现，低血红蛋白浓度，活动性出血，直径＞2cm溃疡及十二指肠球部后壁溃疡等因素明显相关，结论：这些与治疗失败有关的因素有利于临床上识别对内镜注射治疗效果差的十二指肠溃疡出血患者。

Factors Related to the Failure of Endoscopic Injection Therapy for BleedingDuodenal Ulcer

Objective:To assess the factors that may cause failure of endoscopic injection in patients bleeding from a doudenal ulcer. Method:Endoscopic injection therapy was performed in 132 patients admitted for a bleeding duodenal ulcer with active hemorrhage or a nonbleeding visible vessel,clinical and endoscopic factors related to the therapeutic failure were analysed.Results:The efficacy of endoscopy therapy was 83.3%(110 of 132).Endoscopic injection failed in 22 (16.7%) patients:17 continued to bleed or rebleed,and 5 patients could not be treated because of inaccessbility of the lesion.Therapeutic failure was significantly related to :the presence of shock,lower hemogrobin level,active bleeding,the ulcer size larger than 2cm,and the ulcer location on the posterior wall of duodenal bulb.Conclusions:These factors related to the therapeutic failure may be used to identify those patients bleeding from duodenal ulecr who would not benifit from injection therapy.