CAJ | 학술논문

目的：评价内镜下钛夹联合医用胶对阿司匹林和氯吡格雷双联抗血小板所致消化性溃疡出血的治疗效果。方法选取我院2013年12月～2014年10月因急性冠脉综合征或冠状动脉介入手术使用双联抗血小板治疗所致消化性溃疡出血61例，按随机数字奇、偶数分为单独钛夹治疗组和钛夹联合医用胶治疗组进行内镜下止血治疗，2组在性别、年龄、出血量、溃疡大小、部位及Forrest分级方面无明显差异，在质子泵抑制剂使用种类、剂量、疗程等方面均无差异。监测术后72 h内有无再出血。结果治疗后72 h内，单独钛夹治疗组再出血率是钛夹联合医用胶治疗组的5．4倍[17．2％（5／29） vs．3．2％（1／31），χ2＝1．898，P＝0．168]。结论内镜下钛夹联合医用胶治疗双联抗血小板所致消化性溃疡出血与单纯应用钛夹止血相比，再出血率有降低趋势，疗效确切。
목적：평개내경하태협연합의용효대아사필림화록필격뢰쌍련항혈소판소치소화성궤양출혈적치료효과。방법선취아원2013년12월～2014년10월인급성관맥종합정혹관상동맥개입수술사용쌍련항혈소판치료소치소화성궤양출혈61례，안수궤수자기、우수분위단독태협치료조화태협연합의용효치료조진행내경하지혈치료，2조재성별、년령、출혈량、궤양대소、부위급Forrest분급방면무명현차이，재질자빙억제제사용충류、제량、료정등방면균무차이。감측술후72 h내유무재출혈。결과치료후72 h내，단독태협치료조재출혈솔시태협연합의용효치료조적5．4배[17．2％（5／29） vs．3．2％（1／31），χ2＝1．898，P＝0．168]。결론내경하태협연합의용효치료쌍련항혈소판소치소화성궤양출혈여단순응용태협지혈상비，재출혈솔유강저추세，료효학절。
Objective To compare treatment effects between titanium clamp combining cyanoacrylate and titanium clamp alone for peptic ulcer hemorrhage caused by dual antiplatelet . Methods A total of 61 patients between December 2013 and October 2014, who were admitted for peptic ulcer hemorrhage caused by dual antiplatelet for acute coronary syndrome or percutaneous coronary intervention operation , were enrolled in this study .These patients were divided into two groups by odd and even random numbers , which were given the treatment of titanium clamp only or titanium clamp plus cyanoacrylate .The two groups had no differences in gender, age, hemorrhage amount, size and position of ulcer, and Forrest grading.Their treatment of proton pump inhibitor (PPI) had no difference in category, doze, and course.Rebleeding was monitored for 72 hours after treatment. Results Within 72 hours after treatment, the rebleeding rate in single titanium clamp group was 5.4 times of that in the titanium clamp plus cyanoacrylate group [17.2%(5/29) vs.3.2%(1/31),χ2=1.898, P=0.168]. Conclusion Treatment effects of titanium clamp combining cyanoacrylate are much better than titanium clamp alone for peptic ulcer hemorrhage caused by dual antiplatelet , with decreased rebleeding rates .