摘要
目的探讨氩离子凝固术(APC)对胃十二指肠出血患者的疗效和对应激反应的影响。方法选取新疆军区总医院2016年5月至2017年9月收治的胃十二指肠出血患者98例,按治疗方法不同分为两组,对照组49例,给予内镜下肾上腺素注射止血治疗;观察组49例,给予内镜下APC治疗。比较两组临床疗效、初次止血的成功率、再次出血率、转急诊手术率及死亡率;观察皮质醇(cortisol,Cor)、去甲肾上腺素(norepinephrine,NE)及肾上腺素(epinephrine,E)等应激反应指标的变化;记录住院相关指标(出血量、输血量、止血时间及住院时间)及并发症发生情况。结果观察组总有效率为97. 9%,对照组为85. 7%,观察组临床疗效显著优于对照组(P <0. 05)。两组初次止血率、再次出血率、转急诊手术率及死亡率等治疗指标比较,差异均无统计学意义(P> 0. 05)。两组Cor、NE及E等应激反应指标较治疗前明显降低(P <0. 05),且观察组比显著低于对照组(P <0. 05)。观察组的出血量、输血量、止血时间及住院时间等住院相关指标均显著低于对照组(P <0. 05)。观察组术后并发症总发生率为6.1%,显著低于对照组的20. 4%(P <0. 05)。结论内镜下APC对胃十二指肠出血患者的疗效显著,可以有效减轻患者应激反应,减少出血量,缩短出血时间,并可降低术后并发症的发生。
Objective To evaluate the efficacy of argon plasma coagulation in the treatment of gastroduodenal hemorrhage and influence on stress response. Methods From May 2016 to September 2017,98 patients with gastroduodenal hemorrhage were randomly divided into two groups according to different treatment methods. The control group was treated with endoscopic adrenaline injection, and observation group was treated with endoscopic argon plasma coagulation. The total effective rate, the success rate of primary hemostasis, the incidence of re-bleeding, emergency operation and death, the changes of stress response indexes such as cortisol( Cor), norepinephrine( NE) and epinephrine( E), the amount of hemorrhage, blood transfusion, hemostasis, hospital stay, and complications were compared between two groups. Results The total effective rate( 97. 9%) in the observation group was much higher than that in the control group( 85. 7%)( P < 0. 05); there was no significant difference in the treatment indexes of primary hemostasis, re-bleeding, emergency operation and death( P > 0. 05); the stress response indexes of Cor,NE and E in the two groups were significantly lower than those before treatment( P < 0. 05), and the observation group was more significantly lower than the control group( P < 0. 05). The amount of bleeding,blood transfusion, hemostasis time and hospitalization time in the observation group were significantly lower than those in the control group( P < 0. 05); the total incidence of postoperative complications in the observation group( 6. 1%) was significantly lower than that in the control group( 20. 4%)( P < 0. 05).Conclusions Endoscopic argon plasma coagulation has a significant effect on patients with gastroduodenal hemorrhage. It can effectively alleviate the stress reaction, reduce the amount of bleeding, shorten the bleeding time, and reduce the incidence of postoperative complications.
作者
蒋丽丽
于霞
JIANG Li-li;YU Xia(Department of Gastroenterology General Hospital of Xinjiang Military Region Urumqi Xinjiang Uygur Autonomous Region 830000)
出处
《现代消化及介入诊疗》
2018年第6期694-698,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词
胃十二指肠出血
氩离子凝固术
肾上腺素注射
应激反应
出血时间
Gastroduodenal hemorrhage
Argon plasma coagulation
Epinephrine injection
Stress response
Bleeding time
