氩离子凝固器与热探头在内镜治疗重度消化性溃疡出血中的前瞻性比较
Prospective comparison of argon plasma coagulator and heater probe in the endoscopic treatment of major peptic ulcer bleeding.
作者信息
Cipolletta L, Bianco M A, Rotondano G, Piscopo R, Prisco A, Garofano M L
机构信息
Servizio di Gastroenterologia ed Endoscopia Digestiva, ASL NA5, Ospedale Maresca, Torre del Greco, Italy.
出版信息
Gastrointest Endosc. 1998 Aug;48(2):191-5. doi: 10.1016/s0016-5107(98)70163-4.
BACKGROUND
Argon plasma coagulator was prospectively compared with heater probe in patients with bleeding peptic ulcers.
METHODS
Forty-one patients with major stigmata of ulcer hemorrhage were randomly assigned to receive either heater probe (n = 20) or argon plasma coagulation (n = 21) treatment; 40% had active bleeding and 60% had a nonbleeding visible vessel in the ulcer crater. The two groups were similar with respect to all background variables. Episodes of recurrent bleeding were retreated with the same modality as used previously. Patients in whom treatment or retreatment failed underwent emergency surgery.
RESULTS
Initial hemostasis (95% vs. 95.2%), recurrent bleeding (21% vs. 15%), 30-day mortality (5% vs. 4.7%), and emergency surgery (15% vs. 9.5%) were comparable in the heater probe and argon plasma coagulation groups, respectively. Argon plasma coagulation provided faster hemostasis (mean 60 +/- 19 vs. 115 +/- 28 seconds, p < 0.05).
CONCLUSIONS
Argon plasma coagulation is safe and effective. Larger studies in patients with bleeding peptic ulcers are needed to confirm these promising results.
背景
对患有消化性溃疡出血的患者，前瞻性地比较氩离子凝固术与热探头治疗的效果。
方法
41例有溃疡出血主要征象的患者被随机分配接受热探头治疗（n = 20）或氩离子凝固术治疗（n = 21）；40%有活动性出血，60%在溃疡灶有非出血性可见血管。两组在所有背景变量方面相似。复发性出血发作采用与先前相同的方式进行再次治疗。治疗或再次治疗失败的患者接受急诊手术。
结果
热探头组和氩离子凝固术组的初始止血率（95%对95.2%）、复发性出血率（21%对15%）、30天死亡率（5%对4.7%）和急诊手术率（15%对9.5%）分别相当。氩离子凝固术止血更快（平均60±19秒对115±28秒，p<0.05）。
结论
氩离子凝固术安全有效。需要对消化性溃疡出血患者进行更大规模的研究以证实这些有前景的结果。
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