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[目的]对内镜下黏膜注射、金属钛夹和电凝止血治疗上消化道溃疡出血疗效进行比较,为临床治疗溃疡出血寻找更佳的方法。[方法]选取上消化道溃疡并出血患者159例作为研究对象,将其按照治疗方法分为3组:注射组60例,钛夹组52例,电凝组47例,比较3组患者治疗后的即时止血率、72h再出血率、转外科手术率及平均住院天数等情况。[结果]3组患者的即时止血率比较:注射组即时止血率88.3%明显低于钛夹组96.2%、电凝组100%,差异具有统计学意义(P<0.05);钛夹组虽略低于电凝组,但差异无统计学意义(P>0.05)。3组72h内再出血率比较:注射组(15.0%)与钛夹组(11.5%)比较差异无统计学意义(P>0.05);电凝组72h内再出率最低(2.1%),与注射组、钛夹组比较均差异具有统计学意义(P<0.05)。3组转外科手术率比较:注射组为11.7%,钛夹组为7.7%,电凝组为2.1%;注射组与电凝组比较差异有统计学意义(P<0.05),注射组与钛夹组比较、钛夹组与电凝组比较均差异无统计学意义(P>0.05)。3组患者住院天数比较差异无统计学意义(P>0.05),均未出现穿孔等并发症发生。[结论]内镜黏膜下注射止血、金属钛夹止血、电凝止血对溃疡出血患者的即时止血率高,疗效安全、可靠。内镜下金属钛夹和电凝止血治疗溃疡出血,较之于单纯黏膜注射止血的临床效果更可靠,电凝止血更优,且再出血和转外科手术率低,故该治疗方案作为治疗溃疡出血可进行更深入的研究,获得稳定的治疗效果。
[Objective] To compare the curative effect of endoscopic mucosal injection, titanium clip and electrocoagulation hemostasis in the treatment of upper gastrointestinal ulcer bleeding, so as to find a better method for the clinical treatment of ulcer bleeding. [Method] A total of 159 patients with upper gastrointestinal ulcer and hemorrhage were selected as study subjects. They were divided into 3 groups according to the treatment methods: 60 cases in injection group, 52 cases in titanium clamp group and 47 cases in coagulation group. After 3 groups of patients were treated Immediate hemostatic rate, 72h rebleeding rate, surgical rate and the average length of stay in hospital and so on. [Results] The immediate rate of hemostasis was lower in the three groups: the rate of immediate hemostasis in the injection group was significantly lower than that in the titanium group (88.2% vs 96.2%, 100%, respectively) (P <0.05) Lower than the coagulation group, but the difference was not statistically significant (P> 0.05). There was no significant difference in the rate of rebleeding between the three groups within 72h (15.0% vs. 11.5%, P> 0.05). The rate of rebleeding within 72 hours was the lowest (2.1%) in the electrocoagulation group Injection group, titanium clip group were statistically significant differences (P <0.05). In the three groups, the rate of surgical operation was 11.7% in the injection group, 7.7% in the titanium clamp group and 2.1% in the electrocoagulation group. The difference between the injection group and the electrocoagulation group was statistically significant (P <0.05) There was no significant difference between the clamp group and the coagulation clamp group (P> 0.05). There was no significant difference in hospitalization days between the three groups (P> 0.05). No complications such as perforation occurred. [Conclusion] The endoscopic submucosal injection of hemostasis, metal titanium clip to stop bleeding, coagulation and hemostasis in patients with ulcer bleeding in patients with immediate hemostasis, safe and reliable. Endoscopic titanium clip and coagulation to treat hemorrhage ulcer bleeding, compared with simple clinical effect of mucosal injection of hemostasis more reliable, better coagulation and electrocautery, and re-bleeding and surgery rate is low, so the treatment as an ulcer treatment Bleeding can be more in-depth study, access to stable treatment.