Fock K M, Ng T M, Chong Y Y, Chia S C, Chew C N
Department of Medicine, Toa Payoh Hospital, Singapore.
Int Surg. 1995 Apr-Jun;80(2):134-7.
This study aimed to compare the results of bleeding peptic ulcer treated by endoscopic adrenaline injection with controls treated conventionally. Between January 1991 and December 1993, 69 patients with actively bleeding peptic ulcers with visible vessel received endoscopic adrenaline injection. This group of patients was compared with 31 endoscopically similar patients treated conventionally, using H2 blockers with or without surgery, from October 1987 to December 1990 prior to the introduction of endoscopic injection therapy in this hospital. Both groups of patients were comparable in terms of age, haemoglobin level on admission and site of ulcer (gastric or duodenal). Permanent haemostasis was attained with endoscopic adrenaline injection in 97% of our patients. Rebleeding occurred in 9% in the injected group vs 39% in the historical control group (p < 0.005). Three percent of patients in the injected group had emergency surgery compared with 48% in the control group (p < 0.005). The median hospital stay and transfusion requirements in the injected group were 6 days and 2 units respectively vs 8 days and 3 units in the control group but the difference was not statistically significant. We conclude that endoscopic adrenaline injection is effective in the treatment of bleeding peptic ulcer leading to a reduction in rebleeding rate and emergency surgery.
本研究旨在比较内镜下注射肾上腺素治疗出血性消化性溃疡的结果与传统治疗的对照组结果。1991年1月至1993年12月期间，69例有可见血管的活动性出血性消化性溃疡患者接受了内镜下肾上腺素注射。将这组患者与1987年10月至1990年12月期间在本院引入内镜注射治疗之前采用H2受体阻滞剂加或不加手术治疗的31例内镜表现相似的患者进行比较。两组患者在年龄、入院时血红蛋白水平和溃疡部位（胃或十二指肠）方面具有可比性。我们的患者中97%通过内镜下肾上腺素注射实现了永久性止血。注射组的再出血率为9%，而历史对照组为39%（p<0.005）。注射组3%的患者接受了急诊手术，而对照组为48%（p<0.005）。注射组的中位住院时间和输血需求量分别为6天和2单位，而对照组为8天和3单位，但差异无统计学意义。我们得出结论，内镜下肾上腺素注射治疗出血性消化性溃疡有效，可降低再出血率和急诊手术率。
