【摘要】 目的研究消化性溃疡合并血管裸露出血患者的内镜征象与内镜治疗和常规药物治疗的预后之间的关系。方法参考ForreSt分级将136例患者分为4级:Ⅱa、Ⅱa+Ⅰa级、Ⅱa+Ⅰb级、Ⅱa+Ⅱb级。每级患者随机接受内镜下注射治疗与常规药物治疗,反复大出血者外科手术。结果内镜治疗组的即刻止血率均为100.0%,内镜治疗组、药物治疗组的24h止血率分别为100%、39.7%;平均输血量分别为2μ、8μ;再出血率分别为7.4%、45.6%,手术率分别为2.9%、17.6%。结论消化性溃疡合并血管裸露出血的临床表现较重,内镜下治疗的止血效果优于药物治疗,且再出血的发生率和手术率较低。更多还原

【Abstract】 Objective: The endoscopic sign and outcome of endoscopic therapy were investigated, about the visible vessel on the bleeding peptic ulcer. Methods: 136 patients with a visible vessel on the bleeding peptic ulcer were divided into type Ⅱa, type Ⅱa+Ⅰa, type Ⅱa+Ⅰb and type Ⅱa+Ⅱb, according to Forrest classification. The patients of each type were enrolled into endoscopic injection therapy group or medicine therapy group occasionally. Results: The rate of immediate he mostasia in all cases of endoscopic injection therapy group is 100.0% averagely. The relative hemostasis for 24 hours was 100% in endoscopic injection therapy group and 39.7% in medicine therapy group (P<0.01). The incidence of rebleeding within one week was 7.4% and 45.6%, the mean unit of blood infusion was 2μ and 8μ, operation rate are 2.9% and 17.6%, in endoscopic injection therapy group and medicine therapy group respectively. Conclusions: There were more serious symptom in the patients with visible vessel on the bleeding peptic ulcer. Endoscopic injection therapy was more effective in hemostasis, with lower incidence of rebleeding and operation.更多还原