Comparison of haemostatic efficacy for endoscopic injection therapy of epinephrine and combination therapy of epinephrine and hemoclips for bleeding peptic ulcers

Srpski Arhiv za Celokupno Lekarstvo

关键词: peptic ulcer;    bleeding;    endoscopic therapy;    epinephrine;    hemoclips;   

DOI  :  10.2298/SARH1206299G

来源: DOAJ

【 摘 要 】

Introduction. Endoscopic injection therapy of epinephrine is safe andeffective in the treatment of bleeding peptic ulcer, but with high risk ofrebleeding. The combination therapy of epinephrine and hemoclips could leadto a reduction of rebleeding and a potential reduction in mortality.Objective. To investigate the efficacy and safety of epinephrine injectiontherapy and combination therapy with epinephrine and hemoclips in treatingbleeding peptic ulcers. Methods. A prospective randomized study included 58patients with bleeding gastric or duodenal ulcer. In 30 patients endoscopicinjection therapy with diluted epinephrine was applied (group I), while in 28patients combination therapy of epinephrine and hemoclips was applied (groupII). Results. Initial haemostasis was achieved in most patients treated withepinephrine injection therapy (93.3%) and patients treated with combinationtherapy of epinephrine and hemoclips (96.4%). After initial haemostasis wasachieved rebleeding was significantly more frequent in the patients treatedwith epinephrine (28.5%) than in the patients treated with combinationtherapy (3.7%, p<0.05). Two patients treated with epinephrine injectiontherapy were subjected to surgical intervention, whereas no patient treatedwith combination therapy needed surgery. Lethal ending occurred in onepatient treated with epinephrine and in one patient treated with combinationtherapy. The difference between the two groups of patients in need forsurgical intervention and mortality was not statistically significant.Conclusion. Combination therapy with epinephrine and hemoclips is moreefficient than epinephrine alone in the treatment of bleeding peptic ulcers.

【 授权许可】

Unknown