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局部凝血酶喷雾在消化内镜检查中的止血效果。

Hemostatic effect of topical hemocoagulase spray in digestive endoscopy.

作者信息

Wang Tao, Wang Dan-Na, Liu Wen-Tian, Zheng Zhong-Qing, Chen Xin, Fang Wei-Li, Li Shu, Liang Li, Wang Bang-Mao

机构信息

Tao Wang, Dan-Na Wang, Wen-Tian Liu, Zhong-Qing Zheng, Xin Chen, Wei-Li Fang, Shu Li, Li Liang, Bang-Mao Wang, Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China.

出版信息

World J Gastroenterol. 2016 Jul 7;22(25):5831-6. doi: 10.3748/wjg.v22.i25.5831.

Abstract

AIM

To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy.

METHODS

Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 at Center for Digestive Endoscopy, Tianjin Medical University General Hospital were randomly divided into either a study group (n = 39) or a control group (n = 50). The study group was given topical hemocoagulase spray intraoperatively, while the control group was given traditional 8% norepinephrine spray. Hemostatic efficacy was compared between the two groups. Bleeding site, wound cleanliness and perforation were recorded, and the rates of perforation and late bleeding were compared.

RESULTS

Successful hemostasis was achieved in 39 (100%) patients of the study group and in 47 (94.0%) patients of the control group, and there was no significant difference in the rate of successful hemostasis between the two groups. Compared with the control group, after topical hemocoagulase spray in the study group, the surgical field was clearer, the bleeding site was more easily identified, and the wound was cleaner. There was no significant difference in the rate of perforation between the study and control groups (16.7% vs 35.0%, P = 0.477), but the rates of late bleeding (0% vs 15.8%, P = 0.048) and overall complications (P = 0.032) were significantly lower in the study group.

CONCLUSION

Topical hemocoagulase spray has a definite hemostatic effect for oozing bleeding in digestive endoscopy, and this method is convenient, safe, and reliable. It is expected to become a new method for endoscopic hemostasis.

摘要

目的

评估局部应用血凝酶喷雾剂在消化内镜检查中的止血效果。

方法

选取2014年9月至2014年10月在天津医科大学总医院消化内镜中心接受内镜治疗时出现渗血的89例患者,随机分为研究组(n = 39)和对照组(n = 50)。研究组术中给予局部应用血凝酶喷雾剂,对照组给予传统的8%去甲肾上腺素喷雾剂。比较两组的止血效果。记录出血部位、创面清洁度和穿孔情况,并比较穿孔率和迟发性出血率。

结果

研究组39例(100%)患者止血成功,对照组47例(94.0%)患者止血成功,两组止血成功率差异无统计学意义。与对照组相比,研究组局部应用血凝酶喷雾剂后,手术视野更清晰,出血部位更容易识别,创面更清洁。研究组与对照组的穿孔率差异无统计学意义(16.7%对35.0%,P = 0.477),但研究组的迟发性出血率(0%对15.8%,P = 0.048)和总体并发症发生率(P = 0.032)显著更低。

结论

局部应用血凝酶喷雾剂对消化内镜检查中的渗血有确切的止血效果,且该方法方便、安全、可靠。有望成为内镜止血的新方法。

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