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首页> 外文期刊>Journal of gastroenterology and hepatology >Large-volume endoscopic injection of epinephrine plus normal saline for peptic ulcer bleeding.
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Large-volume endoscopic injection of epinephrine plus normal saline for peptic ulcer bleeding.

机译：大剂量内镜下注射肾上腺素加生理盐水治疗消化性溃疡出血。

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BACKGROUND AND AIM: Large-volume endoscopic injection of epinephrine has been proven to significantly reduce rates of recurrent peptic ulcer bleeding. Injection of normal saline may be equally effective for the similar hemostatic effect of local tamponade. The aim of our study was to compare the therapeutic effects of large-volume (40 mL) endoscopic injections of epinephrine, normal saline and a combination of the two in patients with active bleeding ulcers. METHOD: A total of 216 patients with actively bleeding ulcers (spurting or oozing) were randomly assigned to three groups (1:10,000 epinephrine, normal saline or diluted epinephrine plus normal saline). The hemostatic effects and clinical outcomes were compared between the three groups. RESULTS: The initial hemostatic rate was significantly lower in the normal saline group (P < 0.05). The volume of injected solution required for the arrest of bleeding was significantly larger in the normal saline group (P < 0.01). Mean duration for arrest of bleeding was significantly longer in the normal saline group (P < 0.01). There were no significant differences between the three groups with respect to the rates of recurrent bleeding, surgical intervention, 30-day mortality, amount of transfusion and duration of hospitalization. Significant elevation of systolic blood pressure (P < 0.05) and persistent high pulse rate after endoscopic injection were observed in the epinephrine group. CONCLUSIONS: For patients with active bleeding ulcers (spurting or oozing), we recommend a large-volume (40 mL) combination injection using diluted epinephrine to cease bleeding, followed by injection of normal saline to achieve sustained hemostasis.
机译：背景与目的：大剂量内镜下注射肾上腺素已被证明可以显着降低消化性溃疡复发性出血的发生率。注射生理盐水对局部压塞的止血作用可能同样有效。我们的研究目的是比较大剂量（40 mL）内镜下注射肾上腺素，生理盐水以及两者的结合对活动性溃疡患者的治疗效果。方法：将总共216例活动性溃疡（喷射或渗出）患者随机分为三组（1：10,000肾上腺素，生理盐水或稀释的肾上腺素加生理盐水）。比较了三组的止血效果和临床结局。结果：生理盐水组的初始止血率显着降低（P <0.05）。在生理盐水组中，止血所需的注射液量明显更大（P <0.01）。生理盐水组的平均止血时间明显更长（P <0.01）。三组之间在复发出血率，手术干预，30天死亡率，输血量和住院时间方面无显着差异。肾上腺素组观察到内镜注射后收缩压显着升高（P <0.05）和持续高脉率。结论：对于活动性溃疡（喷出或渗出）的患者，我们建议使用稀释的肾上腺素进行大剂量（40 mL）联合注射以止血，然后注射生理盐水以实现持续止血。

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