消化内镜下不同止血夹治疗上消化道出血的疗效及对白蛋白、血红蛋白和血小板水平的影响

目的 比较消化内镜下可旋转重复开闭软组织夹(和谐夹)与金属钛夹止血治疗上消化道出血的应用效果及对患者白蛋白(ALB)、血红蛋白(HGB)和血小板(PLT)水平的影响.方法 回顾性分析2018年1月-2019年12月该院167例上消化道出血患者的临床资料,根据内镜下使用的止血夹不同,分为观察组(和谐夹,n=74)与对照组...

Efficacy of different hemostatic clips under digestive endoscopy on upper gastrointestinal hemorrhage and effects on levels of ALB, HGB and PLT

Objective To compare the application effects of rotating and repeatedly opening-closing soft tissue clip (SureClip) and metal titanium hemostatic clip under digestive endoscopy on upper gastrointestinal hemorrhage and effects on levels of patients albumin (ALB), hemoglobin (HGB) and platelet (PLT).Methods The clinical data of 167 patients with upper gastrointestinal hemorrhage from January 2018 to December 2019 were retrospectively analyzed. According to the different hemostatic clips under endoscopy, the patients were divided into observation group (Sure Clip, n = 74) and control group (Olympus metal titanium clip, n = 93). By propensity score matching, each 48 cases were obtained in the two groups. The immediate hemostasis rate, hemostasis effective rate, re-bleeding rate, the number of titanium clip use, average blood transfusion during hospitalization, postoperative hospital stay, start time of falling of hemostatic clips and changes of ALB, HGB and PLT before and after treatment were compared between the two groups, and the surgical re-operation rate, incidence rates of complications and mortality rate were recorded in the two groups.Results The immediate hemostasis rate in observation group was not significantly different than that in control group (100.00% vs 93.75%) (P > 0.05). The hemostasis effective rate was higher than that in control group (97.92% vs 85.42%) (P < 0.05), and the rebleeding rate was lower than that in control group (4.17% vs 18.75%) (P < 0.05). The number of use of hemostatic clips, blood transfusion and hospital stay in observation group were less or shorter than those in control group, and the start time of falling of hemostatic clips was later than that in control group (P < 0.05). At 7 d after treatment, the levels of ALB and HGB in the two groups were higher than those before treatment (P < 0.05), and the HGB level in observation group was higher than that in control group (P < 0.05). There was no statistically significant difference in the PLT level compared with that before treatment (P > 0.05). There were no statistically significant differences between the two groups in the surgical reoperation rate, incidence rates of complications and mortality rate (P > 0.05).Conclusion Compared with conventional metal titanium clip, SureClip hemostasis under digestive endoscopy for upper gastrointestinal hemorrhage can improve the hemostasis effective rate and reduce the rebleeding rate, with good application prospects.