目的 比較內(nèi)鏡下注射去氨加壓素與腎上腺素治療老年急性消化性潰瘍出血的臨床療效。方法 選取2014年10月—2018年11月楊凌示范區(qū)醫(yī)院收治的老年急性消化性潰瘍出血患者70例作為研究對象。采用隨機數(shù)字表法將患者分為對照組和觀察組，每組各35例。對照組內(nèi)鏡下注入0.1%鹽酸腎上腺素注射液，0.5~1 mL/次，總量控制在2.0~6.0 mL。觀察組注入醋酸去氨加壓素注射液，0.3 μg/kg。觀察兩組患者的臨床療效、止血情況、諾丁漢健康調(diào)查問卷（NHP）和不良反應(yīng)發(fā)生情況。結(jié)果 兩組治療總有效率比較差異無統(tǒng)計學(xué)意義。治療后，觀察組止血時間、即時止血率、再出血率、輸血量和轉(zhuǎn)外科手術(shù)率改善程度均優(yōu)于對照組，但相比差異無統(tǒng)計學(xué)意義。治療后，觀察組患者精力、情感、睡眠、社會生活和軀體活動評分均顯著低于對照組（P<0.05），疼痛評分比較無顯著差異。治療期間，觀察組心血管不良反應(yīng)發(fā)生率顯著低于對照組（P<0.05）。結(jié)論 內(nèi)鏡下注射去氨加壓素治療老年急性消化性潰瘍出血效果與注射腎上腺素相當(dāng)，但內(nèi)鏡下注射去氨加壓素的心血管不良發(fā)應(yīng)發(fā)生率低，患者生活質(zhì)量高，尤其是對于合并心血管疾病的老年患者，值得進(jìn)一步臨床推廣應(yīng)用。

Objective To compare the clinical efficacy of endoscopic injection of desmopressin and epinephrine in treatment of elderly patients with acute peptic ulcer bleeding. Methods A total of 70 cases elderly patients with acute peptic ulcer bleeding admitted to Yangling Demonstrtion Zone Hospital from October 2014 to November 2018 were selected as the research objects. The patients were divided into control group and observation group by random number table method, 35 patients in each group. Patients in the control group was injected with 0.1% Epinephrine Hydrochloride Injection under endoscopy, 0.5-1 mL/time, and the total amount was controlled within 2.0-6.0 mL. Patients in the observation group was injected with Desmopressin Acetate Injection, 0.3 μg/kg. After treatment, clinical efficacy, hemostasis, NHP score, and adverse reactions were observed in two groups. Results There was no significant difference in the total effective rate between two groups. After treatment, hemostasis time, immediate hemostasis rate, rebleeding rate, blood transfusion volume, and conversion rate of surgery in the observation group was better than those in control group, but the difference was not statistically significant. After treatment, the scores of energy, emotion, sleep, social life, and physical activity in the observation group were significantly lower than those in the control group (P<0.05), and there was no significant difference in pain scores. During the treatment, the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). Conclusion The therapeutic effect on endoscopic injection of desmopressin in treatment of elderly patients with acute peptic ulcer bleeding is comparable to and epinephrine. However, the incidence of adverse cardiovascular events caused by endoscopic injection of desmopressin is low and the quality of life of the patients is high, especially for the elderly patients with cardiovascular diseases, which is worthy of further clinical promotion and application.

R975