CAJ | 학술논문

目的：探讨内镜止血在急性非静脉曲张性上消化道出血治疗中的疗效。方法：对286例急性非静脉曲张性上消化道出血患者记录内镜诊断、病变部位、大小及近期出血征象等。病变出血征象采用Forrest分级，将所有患者随机分为内镜下止血治疗（治疗组）和保守治疗（对照组）。内镜止血治疗方法包括尼龙绳结扎止血、钛夹止血、注射止血、钛夹联合注射止血。结果：内镜治疗组进行内镜治疗的病变均为Forrest Ia～II b级，137例（95．8％）患者首次内镜止血成功，其中8例（5．6％）发生再出血，首次内镜治疗成功率为90．2％（129／143）。对照组首次止血成功117例，占81．8％，其中12例（8．4％）发生再出血，首次内镜治疗成功率为73．4％（105／143）。内镜治疗组与对照组相比较有显著性差异（P＜0．05）。结论：内镜下止血治疗起效迅速、疗效确切，是急性非静脉曲张性上消化道出血患者的首选治疗方法；Forrest Ia～IIb级的出血病变应该进行内镜治疗。
목적：탐토내경지혈재급성비정맥곡장성상소화도출혈치료중적료효。방법：대286례급성비정맥곡장성상소화도출혈환자기록내경진단、병변부위、대소급근기출혈정상등。병변출혈정상채용Forrest분급，장소유환자수궤분위내경하지혈치료（치료조）화보수치료（대조조）。내경지혈치료방법포괄니룡승결찰지혈、태협지혈、주사지혈、태협연합주사지혈。결과：내경치료조진행내경치료적병변균위Forrest Ia～II b급，137례（95．8％）환자수차내경지혈성공，기중8례（5．6％）발생재출혈，수차내경치료성공솔위90．2％（129／143）。대조조수차지혈성공117례，점81．8％，기중12례（8．4％）발생재출혈，수차내경치료성공솔위73．4％（105／143）。내경치료조여대조조상비교유현저성차이（P＜0．05）。결론：내경하지혈치료기효신속、료효학절，시급성비정맥곡장성상소화도출혈환자적수선치료방법；Forrest Ia～IIb급적출혈병변응해진행내경치료。
Objective:To evaluate the clinical effect of endoscopic hemostasis in acute nonvariceal upper gastrointestinal hemorrhage .Methods :This was a retrospective study of 286 patients with acute nonvariceal upper gastrointestinal bleeding and receiving endoscopic treatment who were admitted to our hospital .All patients were randomly divided into endoscopic therapy group and internal medicine conservative treatment group .Endoscopic treatment comprised nylon rope ,titanium clips ,injection ,injection and combination therapy .Results :Hemorrhagic le‐sions were selected for endoscopic treatment ,in which 137 patients(95 .8% ,137/143)underwent first endoscopic he‐mostasis successfully ,while rehemorrhage occurred in 8 patients(5 .6% ,8/143) .The first hemostatic achievement rate was 90 .2% (129/143) .In the control group 117 patients(81 .8% ,117/143)underwent first endoscopic hemosta‐sis successfull ,while rehemorrhage occurred in 12 patients(8 .4% ,12/143) .The first hemostatic achievement rate was 73 .4% (105/143) .Endoscopic treatment group compared with the control group was statistically significant(P<0 .05) .Conclusion :Endoscopic hemostatic therapy is the preferred emergency treatment in acute nonvariceal upper gastrointestinal bleeding .