中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2014年
6期
924-925,927
,共3页
消化内镜%胃十二指肠出血%注射止血法%氩离子凝固术
消化內鏡%胃十二指腸齣血%註射止血法%氬離子凝固術
소화내경%위십이지장출혈%주사지혈법%아리자응고술
Gastrointestinal endoscopy%Gastroduodenal bleeding%Injection hemostasis%Argon plasma coagulation
目的：对经消化内镜治疗胃十二指肠出血的治疗方法及其临床治疗效果进行临床研究。方法：选自2012年1~12月进入我院进行治疗的胃十二指肠出血的120例患者。将这120例患者随机分为两组,每组60例患者。两组患者均给予胃镜检查得以证实患有胃十二指肠出血疾病,对两组患者的心率、血压、呼吸、血氧和脉搏进行监护,并进行低流量吸氧；需要对两组患者禁食,洗胃,并且补充血容量,必要时还要输血,同时静脉注射奥美拉唑40mg/次,每天2次,共用7d。在此基础之上,两组患者采用不同的治疗方法,其中一组采用注射止血法进行治疗,另外一组患者采用氩离子凝固术,即APC进行治疗。将两组患者分别命名为注射组和APC组。本次临床研究为1周,在临床研究的1周内对采用不同方法治疗胃十二指肠出血的临床疗效进行观察。对比两组患者临床治疗结果。结果：注射组的再出血率以及送至急诊手术率均高于APC组。注射组的60例患者,45例显效,8例有效,7例无效,总有效率为88.3%。APC组的60例患者,49例显效,7例有效,4例无效,总有效率为93.3%。注射组治疗后疼痛15例,出血12例,穿孔4例,总并发症发生率为27%。APC组治疗后疼痛2例,出血5例,未发生穿孔,总并发症发生率为11.7%。结论：采用APC方法治疗胃十二指肠出血具有很好的临床疗效,APC组的各项并发症的发生率均低于注射组,APC组的总并发症发生率也低于注射组,值得临床推广。
目的：對經消化內鏡治療胃十二指腸齣血的治療方法及其臨床治療效果進行臨床研究。方法：選自2012年1~12月進入我院進行治療的胃十二指腸齣血的120例患者。將這120例患者隨機分為兩組,每組60例患者。兩組患者均給予胃鏡檢查得以證實患有胃十二指腸齣血疾病,對兩組患者的心率、血壓、呼吸、血氧和脈搏進行鑑護,併進行低流量吸氧；需要對兩組患者禁食,洗胃,併且補充血容量,必要時還要輸血,同時靜脈註射奧美拉唑40mg/次,每天2次,共用7d。在此基礎之上,兩組患者採用不同的治療方法,其中一組採用註射止血法進行治療,另外一組患者採用氬離子凝固術,即APC進行治療。將兩組患者分彆命名為註射組和APC組。本次臨床研究為1週,在臨床研究的1週內對採用不同方法治療胃十二指腸齣血的臨床療效進行觀察。對比兩組患者臨床治療結果。結果：註射組的再齣血率以及送至急診手術率均高于APC組。註射組的60例患者,45例顯效,8例有效,7例無效,總有效率為88.3%。APC組的60例患者,49例顯效,7例有效,4例無效,總有效率為93.3%。註射組治療後疼痛15例,齣血12例,穿孔4例,總併髮癥髮生率為27%。APC組治療後疼痛2例,齣血5例,未髮生穿孔,總併髮癥髮生率為11.7%。結論：採用APC方法治療胃十二指腸齣血具有很好的臨床療效,APC組的各項併髮癥的髮生率均低于註射組,APC組的總併髮癥髮生率也低于註射組,值得臨床推廣。
목적：대경소화내경치료위십이지장출혈적치료방법급기림상치료효과진행림상연구。방법：선자2012년1~12월진입아원진행치료적위십이지장출혈적120례환자。장저120례환자수궤분위량조,매조60례환자。량조환자균급여위경검사득이증실환유위십이지장출혈질병,대량조환자적심솔、혈압、호흡、혈양화맥박진행감호,병진행저류량흡양；수요대량조환자금식,세위,병차보충혈용량,필요시환요수혈,동시정맥주사오미랍서40mg/차,매천2차,공용7d。재차기출지상,량조환자채용불동적치료방법,기중일조채용주사지혈법진행치료,령외일조환자채용아리자응고술,즉APC진행치료。장량조환자분별명명위주사조화APC조。본차림상연구위1주,재림상연구적1주내대채용불동방법치료위십이지장출혈적림상료효진행관찰。대비량조환자림상치료결과。결과：주사조적재출혈솔이급송지급진수술솔균고우APC조。주사조적60례환자,45례현효,8례유효,7례무효,총유효솔위88.3%。APC조적60례환자,49례현효,7례유효,4례무효,총유효솔위93.3%。주사조치료후동통15례,출혈12례,천공4례,총병발증발생솔위27%。APC조치료후동통2례,출혈5례,미발생천공,총병발증발생솔위11.7%。결론：채용APC방법치료위십이지장출혈구유흔호적림상료효,APC조적각항병발증적발생솔균저우주사조,APC조적총병발증발생솔야저우주사조,치득림상추엄。
Clinical study on the treatment method and its clinical treatment effect of gastroduodenal hemorrhage by gastrointestinal endoscopy.Methads:120 patients,registered into Dongguan Tungwah Hospital from January 2012 to December 2012,were randomly divided into 2 groups.60 patients in each group.All the patients of the two groups were treated with endoscopy examination to confirm that patients have gastroduodenal bleeding disease.The patients were given to the monitoring of heart rate,blood pressure,respiration,blood oxygen,pulse,etc,and low-flow oxygen.The following procedure of therapy include no food,gastric lavage,blood volume complement,if necessary,blood transfusion,intravenous omeprazole 40mg/times,2 times a day,for 7d.Based on the mentioned above,the patients of two groups were also given different treatment,one group with injection hemostasis,the another with argon plasma coagulation,APC treatment.These two groups were named as the injection group and the APC group.The time of this clinical study is one week,at the same time,the clinical efficacy of different treatment with gastroduodenal bleeding were observed,Compare 2 groups of patients clinical treatment results..Results:Rebleeding rate of the injection group and sent to the emergency surgery were higher than the APC group.The injection group of 60 patients,45 cases were markedly effective,8 cases were effective,7 cases were ineffective,the total effective rate was 88.3%.The APC group of 60 patients,49 cases were markedly effective,7 cases were effective,4 cases were ineffective,the total effective rate was 93.3%.In the Injection group,15 patients feel pain after the treatment,12 patients with bleeding,4 patients with perforation,the total complication rate was 27%.The APC group after treatment,pain in 2 cases,bleeding in 5 cases,no perforation,the total complication rate was 11.7%.Conclusion:The APC method for the treatment of gastroduodenal bleeding has good clinical efficacy,the complications rate of the APC group were lower than the injection group,the total complication rate of the APC group is also lower than the injection group.So it is believed that the therapeutic method of APC is worthy of clinical application to gastroduodenal bleeding.
