目的 研究内镜下可反复开闭金属夹在结肠息肉电切术后迟发性出血治疗中的应用价值.方法选取2015年4月至2017年6月我院实施结肠息肉电切术后迟发性出血患者60例为研究对象,采用随机数表法分为观察组、对照组各30例,观察组于内镜下使用新型可反复开闭金属夹止血及止血药物,对照组使用一般止血夹及止血药物,对比2组止血率、大便潜血转阴时间、肠鸣音复常时间、住院时间,分析2组治疗后48 h内临床症状严重程度积分,并观察预后情况.结果观察组术中即时止血率100%、有效止血率93%、彻底止血率90%明显高于对照组87%、73%、67%(P<0.05);观察组大便潜血转阴时间、肠鸣音复常时间、住院时间与对照组比较明显短,差异有统计学意义(P<0.05);观察组治疗后12、24、48 h临床症状严重程度积分较对照组低,差异有统计学意义(P<0.05);观察组治疗后7d再出血率7%低于对照组27%(P<0.05),2组外科手术率、并发症发生率、病死率对比差异无统计学意义(P>0.05).结论内镜下可反复开闭金属夹应用于结肠息肉电切术后迟发性出血治疗中,可明显提高止血有效率,可缩短住院时间,同时出血复发率低,值得在临床推广应用.%Objective To study the application value of endoscopic repeated opening and closing metal clip in the treatment of delayed hemorrhage after colonic polyps electrotomy .Methods Sixty cases of patients with de-layed hemorrhage after colonic polyps electrotomy in our hospital from April 2015 to June 2017 were selected for the study and divided into the observation group and the control group with 30 cases in each group according to the random number table method .The observation group was given the new types of repeated opening and closing metal clip and hemostatic drugs to stop bleeding under endoscope ,and the control group was given the general he-mostatic clip and hemostatic drugs to stop bleeding .The hemostasis rate ,bowel sound recovery time and hospital stays were compared between the two groups ,and the clinical symptom severity score at 48 h after treatment were analyzed between the two groups ,and the prognosis was observed .Results The immediate hemostasis rate ,the effective hemostasis rate and the total hemostasis rate were 100% ,93% and 90% respectively in the observation group ,which were higher than those in the control group with 87% ,73% and 67% ,respectively ( P <0 .05) . The bowel sound recovery time and hospital stays were significantly shorter in the observation group than those in the control group ( P <0 .05) .The scores of clinical symptom severity in the observation group were lower than those in the control group at 12 h ,24 h and 48 h after treatment ( P <0 .05) .The re-bleeding rate at 7 d after treatment was 7% in the observation group ,which was lower than that of the control group with 27% ( P <0.05) .There was no significant difference in the surgical rate and the incidence rates of complications and mortali-ty between the two groups ( P >0.05) .Conclusion Endoscopic repeated opening and closing metal clip can sig-nificantly improve the hemostasis effective rate ,and shorten hospital stay with low bleeding recurrence rate in the treatment of delayed hemorrhage after colonic polyps electrotomy ,therefore it is worthy of clinical promotion and application .
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