Llach J, Bordas J M, Salmerón J M, Panés J, García-Pagán J C, Feu F, Navasa M, Mondelo F, Piqué J M, Mas A, Terés J, Rodés J
Department of Gastroenterology, Hospital Clinic i Provincial, Barcelona, Spain.
Gastrointest Endosc. 1996 Feb;43(2 Pt 1):117-20. doi: 10.1016/s0016-5107(06)80111-2.
A prospective, randomized study was performed to compare the hemostatic effect of injection therapy and heater probe thermocoagulation in the treatment of peptic ulcer bleeding.
This study includes 104 patients with upper gastrointestinal bleeding in whom endoscopy revealed a gastric or duodenal ulcer with nonbleeding or bleeding vessel (n = 66), oozing hemorrhage (n = 21), or adherent red clot (n = 17). Patients with other stigmata or clean ulcers were excluded. Patients were randomly assigned during endoscopy to receive injection therapy (adrenaline and polidocanol) (n = 51) or heater probe thermocoagulation (10F probe, at setting of 30 J (n = 53). Therapy was considered successful if there was no further hemorrhage or only minor rebleeding that was controlled with a second endoscopic procedure. Patients with major rebleeding or failure of retreatment underwent emergency surgery.
There were no significant differences in effectiveness between injection therapy and thermocoagulation in any of the assessed parameters: the percentage of patients with major recurrent hemorrhage (4% vs 6%) or minor rebleeding (16% vs 17%), need for emergency surgery (two patients from each group), transfusion requirement (0.45 +/- 0.9 units vs 0.51 +/- 1.1 units), the mean number of hospitalization days (7.1 +/- 4.2 vs 6.9 +/- 4.9), and mortality (one patient from each group died).
Injection therapy and heater probe have similar efficacies in the treatment of bleeding peptic ulcers.
进行了一项前瞻性随机研究，以比较注射疗法和热探头热凝术在治疗消化性溃疡出血中的止血效果。
本研究纳入104例上消化道出血患者，内镜检查显示胃或十二指肠溃疡伴有无出血或出血血管（n = 66）、渗血（n = 21）或附着红色血栓（n = 17）。排除有其他病变特征或清洁溃疡的患者。在内镜检查期间，患者被随机分配接受注射疗法（肾上腺素和聚多卡醇）（n = 51）或热探头热凝术（10F探头，设置为30 J）（n = 53）。如果没有进一步出血或仅有少量再出血且通过第二次内镜手术得以控制，则认为治疗成功。发生大量再出血或再次治疗失败的患者接受急诊手术。
在任何评估参数中，注射疗法和热凝术的有效性均无显著差异：大量复发性出血患者的百分比（4%对6%）或少量再出血患者的百分比（16%对17%）、急诊手术需求（每组2例患者）、输血需求（0.45±0.9单位对0.51±1.1单位）、平均住院天数（7.1±4.2对6.9±4.9）以及死亡率（每组各1例患者死亡）。
注射疗法和热探头在治疗出血性消化性溃疡方面具有相似的疗效。
