SO SÁNH KẾT QUẢ CẦM MÁU BẰNG KẸP CLIP VÀ KẸP CLIP KẾT HỢP VỚI TIÊM CẦM MÁU Ở BỆNH NHÂN XUẤT HUYẾT TIÊU HÓA DO LOÉT DẠ DÀY - TÁ TRÀNG

Abstract

Bleeding peptic ulcer is the most common cause of hospitalization due to gastrointestinal diasease. The endoscopic hemoclip method is a safe and effective hemostatic therapy for managing bleeding peptic ulcer, there have been few randomized clinnical trials to evaluate their efficacy. However, there are not many studies evaluating the hemostatic efficacy of endoscopic hemoclip in combination with other methods. Objective: To compare bleeding control efficacy of hemoclip versus hemoclip combined with 1/10.000 adrenalin injection peptic ulcer bleeding. Methods: From November 2016 to September 2017, a total of 50 patients with Forrest Ia, Ib, IIa,IIb were divided to 2 groups. The first group received endoscopic hemoclip (N=21) and the second one was injected adrenalin combined with hemoclip (N=29). All of patients followed-up within at least 72 hours. Results: All patients were controlled bleeding during endoscopy procedure. Rebleeding occurred in three patients (14,3%) in the hemoclip group and one patient (3,4%) in the combined group (P >0,05). All of rebleeding patients were perfomed second hemostatic endoscopic. Three patients in the hemoclip group were successful, but we failed to obtain hemostasis with the patient of combined group. After that, this patient was transferred to surgery department, no mortality was recorded. There was no statistically significantly difference between the two groups in the volume of blood, duration of hospital stay, the rate of operation and mortality. Conclusion: The combined method does not provide substantial advantage over the hemoclip method alone in the hemostatic management of bleeding peptic ulcers.