胃镜下注射肾上腺素联合生物胶喷洒治疗消化性溃疡活动性出血的临床研究

目的 探讨胃镜下注射肾上腺素联合生物胶喷洒治疗消化性溃疡活动性出血的疗效.方法 回顾性分析2019年2月-2020年1月自贡市第一人民医院收治的143例消化性溃疡活动性出血患者的临床资料,按不同治疗方法分为3组.其中,A组(n=44)采用胃镜下注射肾上腺素+静脉注射奥美拉唑治疗,B组(n=48)采用胃镜下生物胶喷洒+静...

Clinical study on the treatment of active bleeding of peptic ulcer with adrenaline injection combined with bioglue under gastroscope

Objective To explore the effect of epinephrine injection combined with bioglue spraying under gastroscope in the treatment of active bleeding of peptic ulcer.Methods The clinical data of 143 patients with peptic ulcer active bleeding from February 2019 to January 2020 were retrospectively analyzed. Among them, group A (n = 44) were treated with epinephrine injection under gastroscope and omeprazole intravenous injection, group B (n = 48) were treated with biogel spraying under gastroscope and omeprazole intravenous injection, group C (n = 51) were treated with epinephrine injection under gastroscope and biogel spraying and omeprazole intravenous injection. The clinical efficacy, hemostasis time, hospitalization time, the times of hematemesis and melena within 7 days after treatment, rebleeding rates and the incidences of adverse reactions were compared among the three groups.Results The proportion of significant effect, effective and invalid in group A was 15, 17 and 12 cases respectively. The proportion of significant effect, effective and invalid in group B was 17, 19 and 12 cases respectively. The significant, effective and invalid proportion in group C was 22, 27 and 2 case, respectively. There was a significant difference in clinical efficacy distribution among the three groups (P < 0.05). The difference in the total effective rates of the three groups was statistically significant (P < 0.05). The total effective rates of group C was significantly higher than those of group A and group B (96.08%, 72.73% and 75.00%, P < 0.01). On the 7th day of treatment, the hemoglobin levels of group A, B and C were (92.56 ± 10.25) g/L, (94.02 ± 11.37) g/L and (118.31 ± 12.48) g/L, respectively. And hematocrit of group A, B and C were (38.71 ± 5.36)%, (37.08 ± 5.19) %, and (45.06 ± 5.26) %, respectively. There was no statistical difference in the levels of hemoglobin and hematocrit between group A and group B (P > 0.05), and the levels of hemoglobin and hematocrit in group C were higher than those in group A and group B (P < 0.05). The hemostasis time of group A, group B and group C were (4.34 ± 0.75) d, (4.29 ± 0.84) d and (1.68 ± 0.29) d, respectively, the length of stay were (14.85 ± 3.30) d, (15.02 ± 3.27) d and (9.24 ± 2.98) d, respectively, the haematemesis times within 7 days of treatment were (2.66 ± 0.46) times, (2.57 ± 0.42) times and (1.65 ± 0.44) times, respectively, the times of black stool within 7 days were (3.21 ± 0.52) times, (3.08 ± 0.49) times and (1.96 ± 0.46) times, respectively. There were no statistical difference in the hemostasis time, hospitalization time, hematemesis times within 7 days after treatment, frequency of black stool and rebleeding rates between the group A and B (P > 0.05). The hemostasis time and hospitalization time in group C were markedly shorter than those in group A and group B (P < 0.05). The times of hematemesis and melena within 7 days after treatment were significantly less than those in group A and group B (P < 0.05), and the rebleeding rate of group C was significantly lower than those in group A and group B (9.80%, 45.45% and 33.33%, P < 0.01). There was no significant difference in the incidences of adverse reactions among the three groups (P > 0.05).Conclusion The treatment of peptic ulcer active bleeding by injecting adrenaline under gastroscope combined with spraying biological glue can improve the therapeutic effect, speed up hemostasis, improve the condition of hematemesis and melena, reduce the rate of rebleeding, shorten the length of hospital stay, which is safe, it is worthy of clinical application.