Sebghatollahi Vahid, Minakari Mohammad, Tamizifar Babak, Ebrahimi Amrollah, Dashti Gholam Reza
Assistant Professor, Department of Internal Medicine, School of medicine, Az-Zahra hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Associate Professor, Department of Internal Medicine, School of medicine, Az-Zahra hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Middle East J Dig Dis. 2020 Oct;12(4):271-277. doi: 10.34172/mejdd.2020.193.
BACKGROUND This clinical investigation aimed to compare the efficacy of treatment of peptic ulcer hemorrhage by argon plasma coagulation (APC) via contact heat probe method (heater probe) along with epinephrine injection. METHODS 100 patients who underwent endoscopic treatment, were randomly divided into two groups consisting of 50 patients each. In the first group, an intervention was performed using foot pedal and 2.3 mm and 3.2 mm argon probes placed in a 2 to 8 mm distance of delivery place leading to plasma coagulation, sufficient necrosis and hemostasis. In the second group, wound press contact probe was used for wound healing with 15 watts of heat for about 25 degrees, causing coagulation and hemostasis. To evaluate and compare the ulcer treatment in both groups, the patient progress results were monitored for a period of one month from the day of discharge. Statistical analyses of data were performed using SPSS software version 22 along with Chi-square test and T-test. RESULTS No significant difference observed in two groups in term of age, sex and clinical symptoms, but patients treated with APC method had higher hemoglobin levels ( < 0.001). The duration of intervention and abdominal bloating in APC group was significantly higher with two cases of re-admission. In HP group, 3 cases (6.3%) had treatment failure and an average transfused blood was significantly higher in the HP group ( < 0.001). CONCLUSION Endoscopy treatment duration was significantly lower in patients treated with the HP method due to separate washing route. HP method seems to be more appropriate for treatment of cases with abdominal bloating, distal gastric lesion and HP bulbs.
背景 本临床研究旨在比较通过接触热探头法（热探头）联合肾上腺素注射进行氩等离子体凝固（APC）治疗消化性溃疡出血的疗效。方法 100例行内镜治疗的患者被随机分为两组，每组50例。第一组采用脚踏装置，将2.3毫米和3.2毫米的氩探头放置在距输送部位2至8毫米处进行干预，实现等离子体凝固、充分坏死和止血。第二组使用伤口压迫接触探头，以15瓦的热量在约25度下促进伤口愈合，实现凝血和止血。为评估和比较两组的溃疡治疗情况，从出院日起对患者的进展结果进行为期一个月的监测。使用SPSS 22软件并结合卡方检验和t检验对数据进行统计分析。结果 两组在年龄、性别和临床症状方面无显著差异，但接受APC治疗的患者血红蛋白水平更高（<0.001）。APC组的干预持续时间和腹胀情况显著更高，有2例再次入院。在热探头组，3例（6.3%）治疗失败，热探头组的平均输血量显著更高（<0.001）。结论 由于冲洗路径不同，热探头法治疗的患者内镜治疗持续时间显著更短。热探头法似乎更适合治疗腹胀、胃远端病变和热探头球部的病例。
