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目的评估内镜下钛夹联合药物治疗非静脉曲张性上消化道出血的止血效果及机体的应激和炎症程度。方法将2012年8月至2014年12月间在本院接受住院治疗的92例非静脉曲张性上消化道出血患者纳入研究,根据治疗方式不同分为接受药物治疗的对照组(45例)和接受内镜下钛夹联合药物治疗的观察组(47例)。对比2组患者治疗后的止血效果、氧化应激及炎症相关因子水平差异。结果观察组患者接受治疗后的总出血量少于对照组,有效止血、内镜治疗康复比例均高于对照组(P<0.05);观察组接受治疗后的血清Vit E水平[(23.17±1.98)μmol/L]高于对照组[(18.96±1.65)μmol/L],晚期蛋白质氧化产物(AOPP)、丙二醛(MDA)、皮质醇(Cor)、生长激素(GH)、抗利尿激素(ADH)、血糖(BS)水平低于对照组(P<0.05);观察组治疗后3 h及12 h,血清C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、IL-6、肿瘤坏死因子-α(TNF-α)值低于对照组,IL-10值高于对照组(P<0.05)。结论非静脉曲张性上消化道出血患者接受内镜下钛夹联合药物治疗,可以有效提升止血效果,优化全身氧化应激及炎症状态,具有积极的临床意义。
Abstract：Objective To assess the hemostatic effect of endoscopic titanium-clip combined with drugs on non-variceal upper gastrointestinal bleeding and evaluation on stress and inflammation. Methods Patients with non-variceal upper gastrointestinal bleeding admitted into the hospital from August 2012 to December 2014 were enrolled for the study. Those who received drug treatment were assigned as the control group,and those who were given endoscopic titanium-clip combined with drugs were assigned as the observation group. After treatment,differences in hemostatic effect and levels of oxidative stress and inflammation-related factors were compared between the 2 groups. Results Total blood loss of the observation group after treatment was less than that of the control group,and the rate of effective hemostasis and rehabilitation after endoscopic treatment were obviously higher than that of the control group( P < 0.05). Serum Vit E level of the observation group after treatment was higher than that of the control group,and AOPP,malondialdehyde( MDA),Cortisol( Cor),growth hormone( GH),antidiuretic normone( ADH) and blood sugar( BS) levels were lower than those of the control group( P < 0. 05). Three and 12 hours after treatment,serum C-reative protein( CRP),interleukin-1β( IL-1β),interleukin-6( IL-6) and tumor necrosis factor-α( TNF-α) values of the observation group were lower than those of the control group,however,IL-10 value was higher than that of the control group( P < 0. 05). Conclusion Endoscopic titanium-clip combined with drugs in the treatment of patients with non-variceal upper gastrointestinal bleeding could effectively enhance hemostatic effect and optimize systemic oxidative stress and inflammation,which was of positive clinical significance.
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基本信息:
中图分类号:R573.2
引用信息:
[1]张献文,竹建强,冯凯祥.内镜下钛夹联合药物治疗非静脉曲张性上消化道出血的止血效果及机体的应激和炎症程度评估[J].海军医学杂志,2017,38(01):46-49.