CAJ | 학술논문

目的观察内镜下金属钛夹与药物注射治疗Dieulafoy溃疡并活动性出血的临床疗效。方法对2009年1月－2013年12月我院内镜明确诊断为Dieulafoy溃疡伴活动性出血，且予以内镜下治疗62例患者的临床资料进行回顾性分析。根据治疗方式不同，分为钛夹组与药物注射组，钛夹组35例于内镜下金属钛夹止血治疗，药物注射组27例于内镜下局部注射肾上腺素止血治疗。对比两组即时止血率、有效止血率、再出血率、外科手术率之间的差异。结果钛夹组即时止血率及有效止血率明显高于药物注射组，再出血率、外科手术率明显低于药物注射组，P﹤0.05，具有统计学意义；药物注射组出现4例心悸、3例血压升高并发症，钛夹组术后无明显并发症，两组均未出现死亡患者。结论与药物注射治疗相比，金属钛夹治疗Dieulafoy溃疡伴活动性出血具有止血迅速、成功率高、复发出血率低、无并发症，可作为内镜下治疗止血首选方式。
목적관찰내경하금속태협여약물주사치료Dieulafoy궤양병활동성출혈적림상료효。방법대2009년1월－2013년12월아원내경명학진단위Dieulafoy궤양반활동성출혈，차여이내경하치료62례환자적림상자료진행회고성분석。근거치료방식불동，분위태협조여약물주사조，태협조35례우내경하금속태협지혈치료，약물주사조27례우내경하국부주사신상선소지혈치료。대비량조즉시지혈솔、유효지혈솔、재출혈솔、외과수술솔지간적차이。결과태협조즉시지혈솔급유효지혈솔명현고우약물주사조，재출혈솔、외과수술솔명현저우약물주사조，P﹤0.05，구유통계학의의；약물주사조출현4례심계、3례혈압승고병발증，태협조술후무명현병발증，량조균미출현사망환자。결론여약물주사치료상비，금속태협치료Dieulafoy궤양반활동성출혈구유지혈신속、성공솔고、복발출혈솔저、무병발증，가작위내경하치료지혈수선방식。
Objective To observe the clinical curative effect of the treatments with metal titanic clip and drug injection on bleeding Dieulafoy ulcer. Methods A retrospective analysis was made to the clinical data of 62 cases with confirmed diagnosis of bleeding Dieu-lafoy ulcer by endoscope in my hospital during the period from Jan., 2009 to Dec., 2013;the 62 cases were divided into 2 groups:metal titanic clip group (n=35) and drug injection group (n=27);hemostatic treatment with mental titanic clip was performed to cases in men-tal titanic clip group while local injection of epinephrine for hemostasis under endoscope was performed to cases in drug injection group;the instant hemostatic rates, effective hemostatic rates, reoccurrences of bleeding and the rates of surgery in the 2 groups were compared. Results The instant hemostatic rate and the effective hemostatic rate of the cases in mental titanic clip group were much high-er than those of the cases in drug injection group;the reoccurrence of bleeding and the rate of surgery of the cases in mental titanic clip group were much lower than those of the cases in drug injection group (P<0.05), the difference was of statistical significance;4 cases in drug injection group had heart palpitations and 3 cases had complications of increased blood pressure;no obvious complications were observed in metal titanic clip group;no death occurred in both groups. Conclusions Compared with drug injection, hemostatic treatment with mental titanic clip is of fast hemostasis, high successful rate, low reoccurrence of bleeding, no complications, it can be the first choice for hemostatic treatment under endoscope.