钱欧 徐兰英 官锦惠 潘玉凤

【摘要】 目的：比較内镜双极电凝止血与常规止血方法对急性非静脉曲张性上消化道出血（acute non-variceal upper gastrointestinal bleeding，ANVUGIB）的疗效。方法：回顾分析笔者所在医院2018年1-7月收治的342例急性非静脉曲张性上消化道出血患者，按其止血方法分为双极电凝组和传统组。传统组（n=128）采取常规止血方式进行治疗，双极电凝组（n=214）采取内镜双极电凝止血，比较两组再出血发生率、穿孔发生率、手术费用等情况。结果：双极电凝组再出血率（3.7%）低于传统组（11.5%），差异有统计学意义（字2=7.880，P<0.05）;双极电凝组术后未出现穿孔并发症，传统组则出现穿孔3例（2.34%），差异有统计学意义（字2=4.992，P<0.05）;双极电凝组平均手术费为（2 252.25±287.95）元，低于传统组的（2 387.03±397.40）元，差异有统计学意义（t=9.785，P<0.05）。结论：内镜双极电凝止血效果优于传统方法，且费用较低，值得临床推广。

【关键词】 急性非静脉曲张性上消化道出血 内镜双极电凝止血 常规止血 临床效果

doi：10.14033/j.cnki.cfmr.2020.17.064 文献标识码 B 文章编号 1674-6805（2020）17-0-03

A Retrospective Controlled Study of Endoscopic Hemostasis in Acute Non-varicose Upper Gastrointestinal Bleeding/QIAN Ou， XU Lanying， GUAN Jinhui， PAN Yufeng. //Chinese and Foreign Medical Research， 2020， 18（17）： -152

[Abstract] Objective： To compare the curative effect of endoscopic bipolar electrocoagulation hemostasis and conventional hemostatic methods on acute non-variceal upper gastrointestinal bleeding （ANVUGIB）. Method： A retrospective analysis of 342 patients with acute non-variceal upper gastrointestinal bleeding was carried out from January to July 2018. According to their hemostasis methods， they were divided into the bipolar electrocoagulation group and the conventional group. The conventional group （n=128） was treated with conventional hemostasis， while the bipolar electrocoagulation group （n=214） was treated with endoscopic bipolar electrocoagulation. The incidence of rebleeding and perforation， the cost of operation were compared between the two groups. Result： The rate of rebleeding in the bipolar electrocoagulation group （3.7%） was lower than that in the conventional group （11.5%）， the difference was statistically significant （字2=7.880， P<0.05）. No postoperative perforation complications occurred in the bipolar electrocoagulation group， while 3 cases of perforation occurred in the conventional group （2.34%）， the difference was statistically significant （字2=4.992， P<0.05）. The average operation cost in the bipolar electrocoagulation group was （2 252.25±287.95） yuan， which was lower than （2 387.03±397.40） yuan in the conventional group， the difference was statistically significant （t=9.785， P<0.05）. Conclusion： The hemostatic effect of bipolar electrocoagulation is better than the traditional method， and the cost is lower， which is worthy of clinical promotion.

[Key words] Acute non-varicose upper gastrointestinal bleeding Endoscopic bipolar coagulation hemostasis Routine hemostatic Clinical effect

First-authors address： The First Affiliated Hospital of Fujian Medical University， Fuzhou 350005， China

目前内镜下止血的传统方法主要有局部药物喷洒、机械止血、注射止血和热凝止血等[1]，据报道，传统止血治疗的再出血率可达7.4%～33%，穿孔率可达1.8%～3%[2]。双极电凝止血是电凝止血中的一种，该止血技术较其他传统止血技术具有较好的止血效果及较低的穿孔率[3]。双极电凝止血使用的双极探针就包括美国波士顿科学公司双极电凝止血导管，该探针于2017年2月引进国内，笔者所在医院于2017年5月起在国内率先使用。本文回顾并比较了2018年1-7月笔者所在医院收治的342例急性非静脉曲张性上消化道出血（ANVUGIB）患者，于内镜中心采用双极电凝导管止血方法与其他常规方法进行ANVUGIB止血的疗效对比研究，现报道如下。

1 资料与方法

1.1 一般资料

回顾分析笔者所在医院2018年1-7月收治的342例急性非静脉曲张性上消化道出血患者。纳入标准：均符合相关诊断标准，病历资料完整。……