Chung S C, Leung J W, Steele R J, Crofts T J, Li A K
Combined Endoscopy Unit, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin.
Br Med J (Clin Res Ed). 1988 Jun 11;296(6637):1631-3. doi: 10.1136/bmj.296.6637.1631.
A prospective randomised trial was performed to assess the efficacy of endoscopic injection of adrenaline for actively bleeding ulcers. Emergency endoscopy in 961 patients admitted for upper gastrointestinal haemorrhage identified 68 patients with actively bleeding ulcers. These 68 patients were randomised to receive either endoscopic injection of adrenaline or no endoscopic treatment. After endoscopy both groups were managed in an identical manner, and strict criteria for emergency operation were adhered to in both groups. Bleeding was initially controlled in all 34 patients assigned to the treatment group. Significantly fewer patients in the treatment group than in the control group needed emergency operations (five v 14, respectively). In addition, in the treatment group the median transfusion requirement was significantly less (three v five units of blood) and the median hospital stay shorter (six v eight days). No complications were observed with the injection of adrenaline, and the rate of healing of ulcers in those attending for endoscopy six weeks after discharge was similar in both groups (81% (17 out of 21 patients) in the treatment group v 79% (11 out of 14) in the control group). Injection of adrenaline is effective in stopping bleeding from actively bleeding ulcers.
进行了一项前瞻性随机试验，以评估内镜下注射肾上腺素治疗活动性出血性溃疡的疗效。对961例因上消化道出血入院的患者进行急诊内镜检查，发现68例活动性出血性溃疡患者。这68例患者被随机分为两组，分别接受内镜下注射肾上腺素或不接受内镜治疗。内镜检查后，两组患者的治疗方式相同，且两组均严格遵循急诊手术标准。治疗组的所有34例患者出血最初均得到控制。治疗组需要急诊手术的患者明显少于对照组（分别为5例和14例）。此外，治疗组的中位输血量明显更少（3单位对5单位血液），中位住院时间更短（6天对8天）。注射肾上腺素未观察到并发症，出院六周后接受内镜检查的患者中溃疡愈合率在两组中相似（治疗组为81%（21例中的17例），对照组为79%（14例中的11例））。注射肾上腺素对止住活动性出血性溃疡的出血有效。
