摘要
目的:探讨不同内镜下止血方法对于消化道恶性肿瘤活动性出血的止血效果。方法:回顾性分析2001年1月至2022年3月经解放军总医院第一医学中心消化内科医学部行内镜下止血的消化道恶性肿瘤活动性出血患者的相关临床资料，根据是否只应用肾上腺素行内镜下止血治疗，将患者分为单纯肾上腺素组和其他内镜治疗组(包括内镜下联合肾上腺素止血)，比较两组的即刻止血成功率。结果:共纳入65例消化道恶性肿瘤活动性出血患者，其中单纯肾上腺素组34例、其他内镜治疗组31例，两组的即刻止血成功率分别为82.4% (28/34)、100% (31/31)，组间对比差异有统计学意义(P＝0.025)。内镜操作时间分别为17.5(12，21)min、22(14，36)min，差异有统计学意义(P＝0.020)。两组间对比内镜止血后24 h和72 h再出血率，差异均无统计学意义。结论:对于消化道恶性肿瘤活动性出血的治疗，内镜下电凝止血、机械止血及组织胶注射止血等方法或上述方法与肾上腺素联合使用，优于单纯应用肾上腺素。
Abstract
Objective:This study aimed to investigate the hemostatic contribution of various endoscopic hemostasis methods in managing active hemorrhage caused by gastrointestinal malignancies.Methods:In this study, we conducted a retrospective analysis of the medical records of patients who underwent endoscopic hemostasis to stop active bleeding in gastrointestinal malignancies at the First Medical Center of the PLA General Hospital between January 2001 and March 2022. Patients were divided into two groups based on the endoscopic hemostasis they received: the epinephrine-only group and the other endoscopic hemostatic treatments group, which included a combination with epinephrine.The primary outcome of this research was a comparison of the success rates of hemostasis between the two groups.Results:The study involved 65 individuals who had gastrointestinal malignancies with active bleeding.Of these, 34 were treated solely with epinephrine, while 31 received other endoscopic hemostatic treatments.The immediate hemostasis rates were 82.4% (28/34) and 100% (31/31), respectively, and the difference between the two groups was statistically significant (P=0.025). The endoscopic procedure durations were 17.5(12, 21) minutes and 22(14, 36) minutes for the two groups, respectively, with a statistically significant difference (P=0.020). The rates of rebleeding at 24 and 72 hours after endoscopic hemostasis were not significantly different between the two groups.Conclusion:For the endoscopic management of gastrointestinal malignant active bleeding, electrocoagulation, mechanical hemostasis, cyanoacrylate injection, or a combination of these techniques with epinephrine are preferable than utilizing adrenaline alone.
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