高颖

摘 要：目的 探討消化内镜下局部药物联合去甲肾上腺素治疗上消化道出血临床疗效。方法 选取2014年9月～2017年9月我院收治的上消化道出血患者80例，根据随机数表法分为实验组和对照组，各40例。两组患者入院后均给予吸氧、补液、维持水电解质和酸碱平衡等基础常规治疗，对照组患者使用去甲肾上腺素和云南白药进行治疗，实验组患者在此基础上使用消化内镜下局部用药治疗，观察两组患者治疗总有效率、止血时间、出血量、输血量以及并发症发生情况。结果 实验组总有效率为92.50%，高于对照组的72.50%，差异有统计学意义（P<0.05）；实验组止血时间、出血量、输血量分别为（1.26±0.31）d、（187.61±31.17）ml、（392.21±16.23）ml，均少于对照组的（3.94±0.43）d、（326.99±47.23）ml、（569.58±51.16）ml，差异均具有统计学意义（P<0.05）；实验组不良反应发生率为7.50%，低于对照组的27.50%，差异有统计学意义（P<0.05）。结论 消化内镜下局部药物联合去甲肾上腺素治疗上消化道出血临床疗效显著，减少患者消化道出血情况，且不良反应较少，值得临床进一步推广。

关键词：消化内镜；去甲肾上腺素；上消化道出血

中图分类号：R573.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.032

文章编号：1006-1959（2018）10-0104-03

Clinical Observation of Digestive Endoscopy Combined with Norepinephrine in the Treatment of Upper Gastrointestinal Bleeding

GAO Ying

（Digestive Endoscopy Room，Xian Shuigu Hospital，Jinnan District，Tianjin 300350，China）

Abstract：Objective To investigate the clinical efficacy of local drug and norepinephrine in the treatment of upper gastrointestinal bleeding by digestive endoscopy.Methods 80 patients with upper gastrointestinal bleeding treated in our hospital from September 2014 to September 2017 were selected and divided into experimental group and control group according to the random number table method，with 40 cases in each group.After admission，both groups were given basic oxygen and fluid supplements to maintain basic water and electrolyte balance，the patients in the control group were treated with norepinephrine and Yunnanbaiyao.On the basis of this，the patients in the experimental group were treated with local medication under digestive endoscopy.The total effective rate，the time of hemostasis，the amount of bleeding，the amount of blood transfusion and the incidence of complications were observed in the two groups.Results The total effective rate was 92.50% in the experimental group， which was 72.50% higher than that in the control group，the difference was statistically significant（P<0.05）；the hemostatic time，blood loss，and blood transfusion volume in the experimental group were（1.26±0.31）d，（187.61±31.17）ml，（392.21±16.23） ml，respectively，which were less than those in the control group（3.94±0.43）d，（326.99±47.23）ml，（569.58±51.16）ml，the differences were statistically significant（P<0.05）；the incidence of adverse reactions in the experimental group was 7.50%，which was lower than the 27.50% of the control group，the difference was statistically significant（P<0.05）.Conclusion Digestive endoscopic local drug combined with norepinephrine treatment of upper gastrointestinal bleeding clinical curative effect，reduce the patient's gastrointestinal bleeding，and fewer adverse reactions，it is worth further promotion in the clinic.

Key words：Digestive endoscopy；Norepinephrine；Upper gastrointestinal bleeding

上消化道出血（upper gastrointestinal bleeding）主要指患者食道、胃部、十二指肠、胰管或胆管发生出血，上消化道出血作为消化内科较为常见疾病，其临床症状为呕血、便血、贫血和发热等，该病起病急，且发展迅速，如治疗不及时常可导致休克或多器官衰竭，严重者甚至导致死亡，是消化系统的急危病症，严重影响患者生活质量[1]。上消化道出血发病原因较为复杂，引起患者上消化道出血的疾病主要有急性胃粘膜损害、消化道溃疡、食管胃底静脉曲张和胃癌等，在临床中治疗方案尚未统一，传统治疗给予药物保守治疗，去甲肾上腺素具有收缩血管作用，可减少局部出血，但治疗效果不甚理想，随着医学技术不断进步，消化内镜下止血技术不断成熟，逐渐应用于上消化道止血中[2]。……