10 Fr与7 Fr双极电凝导管联合肾上腺素注射在内镜下治疗消化性溃疡出血中的前瞻性随机对照研究。

A prospective, randomized comparison of 10-Fr versus 7-Fr bipolar electrocoagulation catheter in combination with adrenaline injection in the endoscopic treatment of bleeding peptic ulcers.

作者信息

Paspatis Gregorios A, Charoniti Ioanna, Papanikolaou Nikolaos, Vardas Emmanouil, Chlouverakis Gregorios

机构信息

Department of Gastroenterology, Benizelion General Hospital, and School of Education, University of Crete, Heraklion, Crete, Greece.

出版信息

Am J Gastroenterol. 2003 Oct;98(10):2192-7. doi: 10.1111/j.1572-0241.2003.07691.x.

DOI:10.1111/j.1572-0241.2003.07691.x

PMID:14572567

Abstract

OBJECTIVES

Our study compared the efficacy of bipolar electrocoagulation (gold probe) with 10-Fr (group A) versus 7-Fr (group B) catheter after adrenaline injection in the treatment of bleeding peptic ulcers.

METHODS

A total of 77 consecutive patients with endoscopic evidence of peptic ulcer with active bleeding or a nonbleeding visible vessel were randomly assigned to one of the above protocols. Thirty-nine patients (31 male, eight female, mean age 62 yr) were included in group A and 38 (28 male, 10 female, mean age 61 yr) in group B.

RESULTS

The initial hemostasis rate, rebleeding rate, duration of hospital stay, volume of blood transfused, number of operations needed, and number of deaths were not significantly different between the two groups. The mean number of electrocoagulations and the subsequent mean duration of electrocoagulations were significantly higher in group B patients (7.0 +/- 3.8 and 14.1 +/- 7.6 s, respectively) compared with those of group A (4.6 +/- 2.6 and 9.3 +/- 5.3 s, respectively) (p < 0.01). Multivariate stepwise logistic regression analysis revealed that among sex, age, location of bleeding, ulcer size, endoscopic severity of bleeding, and the size of the gold probes, lesser endoscopic severity of bleeding (chi(2) = 31.1, p < 0.01), large size of the gold probe (chi(2) = 23.9, p < 0.01), and small ulcer size (chi(2) = 13.4, p < 0.01) were the only factors significantly associated with a smaller number of electrocoagulations.

CONCLUSIONS

In this study, the use of large-size gold probes was significantly associated with a lower number of electrocoagulations, resulting in the reduction of electrocoagulation duration. However, the clinical relevance of these findings is questionable because the efficacy of both sizes of gold probe after adrenaline injection in the treatment of bleeding peptic ulcers was similar.

摘要

目的

我们的研究比较了肾上腺素注射后，使用10Fr导管（A组）与7Fr导管（B组）的双极电凝（金探头）治疗消化性溃疡出血的疗效。

方法

共有77例经内镜检查证实为活动性出血或可见非出血血管的消化性溃疡患者，被随机分配至上述方案之一。A组纳入39例患者（31例男性，8例女性，平均年龄62岁），B组纳入38例患者（28例男性，10例女性，平均年龄61岁）。

结果

两组的初始止血率、再出血率、住院时间、输血量、所需手术次数和死亡人数无显著差异。与A组患者（分别为4.6±2.6次和9.3±5.3秒）相比，B组患者的平均电凝次数及随后的平均电凝持续时间显著更高（分别为7.0±3.8次和14.1±7.6秒）（p<0.01）。多因素逐步逻辑回归分析显示，在性别、年龄、出血部位、溃疡大小、内镜下出血严重程度和金探头尺寸中，内镜下出血严重程度较轻（χ²=31.1，p<0.01）、金探头尺寸较大（χ²=23.9，p<0.01）和溃疡尺寸较小（χ²=13.4，p<0.01）是与电凝次数较少显著相关的唯一因素。