胃镜下重酒石酸去甲肾上腺素喷洒与注射治疗急性 非静脉曲张性上消化道出血的疗效比较

目的探讨和比较胃镜下重酒石酸去甲肾上腺素喷洒与注射治疗急性非静脉曲张性上消化道出血(ANVUGIB)的临床疗效。方法选取2015年12月-2017年11月该院收治的92例ANVUGIB患者作为临床研究对象,采用随机数字表法,将入选患者随机分为观察组47例和对照组45例。观察组患者给予胃镜下重酒石酸去甲肾上腺素注射的临床药物治疗,对照组患者则给予胃镜下重酒石酸去甲肾上腺素喷洒的临床药物治疗,并分别对两组患者的临床治疗情况、临床指标变化情况和不良反应发生情况进行比较和分析。结果与对照组患者相比,观察组患者临床治疗的显效率57.45%(27/47)和总有效率91.49%(43/47)均明显提高,而无效率8.51%(4/47)则明显降低,差异均有统计学意义(P 0.05);观察组患者止血成功率91.49%(43/47)明显提高,差异有统计学意义(P 0.05),同时再出血率6.38%(3/47)和急诊手术率2.13%(1/47)则均有所降低,但差异均无统计学意义(P0.05);观察组患者腹部不适、大便频繁、胀气和血压不稳等不良反应总发生率10.65%(5/47)明显降低,差异有统计学意义(P 0.05)。结论胃镜下重酒石酸去甲肾上腺素注射治疗ANVUGIB较喷洒给药疗效更为确切,且预后效果好,并发症少。

Comparative study on the efficacy of gastroscopy with spray and injection norepinephrine bitartrate in treatment of acute non-variceal upper gastrointestinal bleeding

Abstract: Objective To discuss and compare the efficacy of gastroscopy with spray and injection norepinephrine bitartrate in treatment of acute non-variceal upper gastrointestinal bleeding. Methods From January 2015 to December 2017, 92 cases of acute non-variceal upper gastrointestinal bleeding patients were selected as clinical research subjects. The patients were randomly divided into observation group (n = 47) and control group (n = 45). The acute non-variceal upper gastrointestinal bleeding patients in the observation group were treated with gastroscopy with injection norepinephrine bitartrate. The acute non-variceal upper gastrointestinal bleeding patients in the control group were treated with gastroscopy with spray norepinephrine bitartrate. The clinical treatment, changes in clinical indicators, adverse reactions of the patients in two groups were compared and analyzed. Results Compared with control group, the acute non-variceal upper gastrointestinal bleeding patients in the observation group, the clinical treatment effective rate was 57.45% (27/47) and the total effective rate was 91.49% (43/47), there were increased significantly, while the inefficiency rate was 8.51% (4/47), there was decreased significantly, the differences were significant statistically (P < 0.05); the acute non-variceal upper gastrointestinal bleeding patients in the observation group, the success rate of hemostasis was 91.49% (43/47), there was increased significantly, the differences were significant statistically (P < 0.05), meanwhile, the rate of concurrent rebleeding was 6.38% (3/47) and the rate of emergency surgery was 2.13% (1/47), there were both decreased, but the differences were not significant statistically (P > 0.05); the acute non-variceal upper gastrointestinal bleeding patients in the observation group, the total incidence of adverse reactions was 10.65% (5/47), included abdominal discomfort, stool frequency, flatulence, unstable blood pressure, there was decreased significantly, the differences were significant statistically (P < 0.05). Conclusion Gastroscopy with injection norepinephrine bitartrate has more effective effect than the spray administration for patients with acute non-variceal upper gastrointestinal bleeding, and the prognosis was well and complications were fewer.