Department of Gastroenterology and Hepatology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minatoku, Tokyo 108-8329, Japan.
Surg Endosc. 2013 Aug;27(8):3035-8. doi: 10.1007/s00464-013-2860-4. Epub 2013 Mar 7.
We previously reported on the safety and efficacy of bipolar hemostatic forceps for treating nonvariceal upper gastrointestinal (UGI) bleeding. However, no prospective or randomized studies have evaluated the efficacy of bipolar hemostatic forceps. The aim of this study was to evaluate the hemostatic efficacy of using bipolar hemostatic forceps compared with the hemostatic efficacy of the commonly used method of endoscopic hemoclipping for treating nonvariceal UGI bleeding.
A total of 50 patients who required endoscopic hemostasis for UGI bleeding were divided into two groups: those who underwent endoscopic hemostasis using bipolar hemostatic forceps (Group I) and those who underwent endoscopic hemostasis by endoscopic hemoclipping (Group II). We compared the two groups in terms of hemostasis success rate and time required to achieve hemostasis and stop recurrent bleeding.
All (100 %) of 27 patients in Group I and 18 (78.2 %) of 23 patients in Group II were successfully treated using bipolar hemostatic forceps or by endoscopic hemoclipping alone, respectively, indicating a significantly higher success rate for Group I than for Group II (p < 0.05). The time required to achieve hemostasis was 6.8 ± 13.4 min for Group I and 15.4 ± 17.0 min for Group II. One patient in Group I (3.7 %) and four patients in Group II (22.2 %) experienced recurrent bleeding.
Bipolar hemostatic forceps was more effective than endoscopic hemoclipping for treating nonvariceal UGI bleeding.
我们之前报道了使用双极止血钳治疗非静脉曲张性上消化道(UGI)出血的安全性和疗效。然而,尚无前瞻性或随机研究评估双极止血钳的疗效。本研究旨在评估与常用的内镜夹闭止血方法相比,使用双极止血钳治疗非静脉曲张性 UGI 出血的止血效果。
共有 50 例 UGI 出血需行内镜止血的患者被分为两组:接受内镜双极止血钳止血的患者(I 组)和接受内镜夹闭止血的患者(II 组)。我们比较了两组的止血成功率和达到止血及停止再次出血所需的时间。
I 组 27 例患者全部(100%)和 II 组 23 例患者中的 18 例(78.2%)分别仅使用双极止血钳或内镜夹闭成功治疗,I 组的成功率明显高于 II 组(p<0.05)。达到止血所需的时间为 I 组 6.8±13.4 分钟,II 组 15.4±17.0 分钟。I 组 1 例(3.7%)和 II 组 4 例(22.2%)患者出现再次出血。
双极止血钳治疗非静脉曲张性 UGI 出血比内镜夹闭更有效。