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内镜注射治疗十二指肠溃疡出血失败的相关因素分析
http://www.100md.com 《河北医学杂志》 2005年第4期
内镜注射,,十二指肠溃疡出血;内镜注射治疗;失败因素,1资料和方法,2结果,3讨论,参考文献:
     摘要:目的:探讨内镜注射治疗十二指肠溃疡出血患者的失败因素。方法:对168例有活动性出血或裸露血管的十二指肠溃疡出血患者进行内镜注射治疗,并从临床和内镜方面分析注射治疗失败的相关因素。结果:内镜注射治疗的有效止血率为84.5%(142/168)。26例(15.5%)患者注射治疗失败,其中20例患者治疗后继续出血或再出血,6例因出血部位难接近而失败。内镜治疗失败与患者休克表现,低血红蛋白浓度,活动性出血,直径>2cm溃疡及十二指肠球部后壁溃疡等因素明显相关。结论:了解与治疗失败有关的因素有利于临床上识别对内镜注射治疗效果差的十二指肠溃疡出血患者。

    关键词:十二指肠溃疡出血;内镜注射治疗;失败因素

    Factors Related to the Failure of Endoscopic Injection Therapy for Duodenal Ulcer Bleeding

    XU Xiao-jiang,YU Shao-ling,SUI jie

    (Department of Digestive,The Second Affiliated Hospital of Guangdong Medical College,Guangdong Zhanjiang 524003, China)

    Abstract: Objective: To investigate the factors that may cause failure of endoscopic injection in patients with duodenal ulcer bleeding. Method: Endoscopic injection therapy was performed for 168 patients diagnosed as duodenal ulcer bleeding with active hemorrhage or a nonbleeding visible vessel and clinical and endoscopic factors related to the therapeutic failure were analyzed. Results: The effective rate of endoscopic injection therapy was 84.5 %(142 of 168). Endoscopic injection failed in 26 (15.5 %) patients, among which 20 cases continued to bleed or rebleed and because of inaccessibility of the lesion 6 patients could not be treated. Therapeutic failure was significantly related to the presence of patients’ shock, lower hemoglobin level, active bleeding, the ulcer with diameter larger than 2cm, and the ulcer location on the posterior wall of duodenal bulb. Conclusion: These factors related to the therapeutic failure may be used to identify those patients with duodenal ulcer bleeding to whom endoscopic injection therapy is less effective. ......

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