摘要
目的探讨内镜下金属钛夹止血在老年急性非静脉曲张性上消化道出血患者中的应用效果。方法回顾性分析2019年3月至2021年3月确山县人民医院收治的110例老年急性非静脉曲张性上消化道出血患者的临床资料。依照治疗方案将患者分为常规组(48例)和研究组(62例)。对常规组患者采用内镜下注射止血,对研究组患者采用内镜下金属钛夹止血。比较两组临床疗效、止血时间、输血量及治疗前和治疗3 d后血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、抗利尿激素(ADH)、丙二醛(MDA)、胃液pH值。分别于治疗前和治疗3 d后采用疼痛数字评分法(NRS)评定疼痛程度。结果研究组治疗总有效率较常规组高(P<0.05)。研究组止血时间短于常规组,输血量少于常规组(P<0.05)。治疗3 d后,两组血清hs-CRP、TNF-α、ADH、MDA水平低于治疗前,研究组血清hs-CRP、TNF-α、ADH、MDA水平低于常规组(P<0.05)。治疗3 d后,两组胃液pH值升高,研究组胃液pH值高于常规组(P<0.05);治疗3 d后,两组NRS评分均较治疗前降低,研究组NRS评分低于常规组(P<0.05)。结论将内镜下金属钛夹止血应用于老年急性非静脉曲张性上消化道出血患者可显著提高疗效,可缩短止血时间,减少输血量,减轻炎症反应、应激反应、疼痛程度,提高胃液pH值。
Objective To investigate the effect of endoscopic metal titanium clips to hemostasis in elderly patients with acute non-varicose upper gastrointestinal hemorrhage.Methods The clinical data of 110 elderly patients with acute non-varices upper gastrointestinal hemorrhage admitted to Queshan County People’s Hospital from March 2019 to March 2021 were retrospectively analyzed.According to the treatment plan,the patients were divided into routine group(48 cases)and study group(62 cases).Endoscopic injection was used to stop bleeding for the patients in routine group,and the metal titanium clip was used to stop the bleeding by the endoscope for the patients in study group.The clinical efficacy,hemostasis time,blood transfusion volume,and serum high-sensitivity C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),antidiuretic hormone(ADH),malondialdehyde(MDA)and pH value of gastric juice before and 3 days after treatment were compared between the two groups.The pain degree was evaluated by numeric rating scale(NRS)before treatment and 3 days after treatment.Results The total effective rate of treatment in study group was higher than that in routine group(P<0.05).The hemostasis time in study group was shorter than that in routine group,and the blood transfusion volume was less than that in routine group(P<0.05).After 3 days of treatment,the levels of serum hs-CRP,TNF-α,ADH and MDA in the two groups were lower than those before treatment,and the levels of serum hs-CRP,TNF-α,ADH and MDA in study group were lower than those in routine group(P<0.05).After 3 days of treatment,the pH value of gastric juice in the two groups increased,and the pH value of gastric juice in study group was higher than that in routine group(P<0.05).After 3 days of treatment,the NRS score in the two groups were lower than that before treatment,and the NRS score in study group was lower than that in routine group(P<0.05).Conclusion The application of metal titanium clips under endoscopy to elderly patients with acute non-varicose upper gastrointestinal hemorrhage could significantly improve the curative effect,shorten the time of hemostasis,reduce blood transfusion,reduce inflammation,stress response and the degree of pain,and increase gastric pH value.
作者
张金生
叶丽丽
岑华丽
ZHANG Jinsheng;YE Lili;CEN Huali(Department of Gastroenterology,Queshan County People’s Hospital,Zhumadian 463200,China;Emergency Department,Queshan County People’s Hospital,Zhumadian 463200,China;Department of Obstetrics and Gynecology,Queshan County People’s Hospital,Zhumadian 463200,China)
出处
《河南医学研究》
CAS
2021年第30期5607-5609,共3页
Henan Medical Research
关键词
非静脉曲张性上消化道出血
肾上腺素
内镜下金属钛夹
止血时间
non-varicose upper gastrointestinal hemorrhage
adrenaline
metal titanium clip under endoscopy
hemostasis time
