Lin Hwai-Jeng, Lo Wen-Ching, Cheng Yang-Chih, Perng Chin-Lin
Division of Gastroenterology, Department of Medicine, VGH-TAIPEI, Taiwan, R.O.C.
Am J Gastroenterol. 2007 Mar;102(3):539-43. doi: 10.1111/j.1572-0241.2006.00962.x.
Hemoclip placement is an effective endoscopic therapy for peptic ulcer bleeding. Triclip is a novel clipping device with three prongs over the distal end. So far, there is no clinical study concerning the hemostatic effect of triclip placement.
To determine the hemostatic effect of the triclip as compared with that of the hemoclip.
A total of 100 peptic ulcer patients with active bleeding or nonbleeding visible vessels received endoscopic therapy with either hemoclip (N = 50) or triclip placement (N = 50). After obtaining initial hemostasis, they received omeprazole 40 mg intravenous infusion every 12 h for 3 days. The main outcome assessment was hemostatic rate and rebleeding rate at 14 days.
Initial hemostasis was obtained in 47 patients (94%) of the hemoclip group and in 38 patients (76%) of the triclip group (P= 0.011). Rebleeding episodes, volume of blood transfusion, the hospital stay, numbers of patients requiring urgent operation, and mortality were not statistically different between the two groups.
Hemoclip is superior to triclip in obtaining primary hemostasis in patients with high-risk peptic ulcer bleeding. In bleeders located over difficult-to-approach sites, hemoclip is more ideal than triclip.
金属夹置放是治疗消化性溃疡出血的一种有效内镜治疗方法。三爪夹是一种新型的夹闭装置，其远端有三个夹齿。迄今为止，尚无关于三爪夹置放止血效果的临床研究。
比较三爪夹与金属夹的止血效果。
总共100例有活动性出血或可见非出血血管的消化性溃疡患者接受了内镜治疗，其中50例采用金属夹置放，50例采用三爪夹置放。在实现初步止血后，他们每12小时接受40mg奥美拉唑静脉输注，共3天。主要结局评估指标为14天时的止血率和再出血率。
金属夹组47例患者（94%）实现了初步止血，三爪夹组38例患者（76%）实现了初步止血（P = 0.011）。两组之间的再出血事件、输血量、住院时间、需要紧急手术的患者数量和死亡率无统计学差异。
在高危消化性溃疡出血患者中，金属夹在实现初次止血方面优于三爪夹。在难以接近部位的出血患者中，金属夹比三爪夹更理想。
