Efficacy of Conventional Endoscopic Injection of Norepinephrine Combined With Electrocoagulation in Acute Non⁃variceal Upper Gastrointestinal Bleeding in Primary Hospitals
10.3969/j.issn.1008-7125.2022.07.005
- Author:
Wen YU
1
;
Palahati PALIDA
1
;
Aiken AIKEPAER
1
;
Jiankang ZHU
1
;
Zili XIAO
2
;
Tao SUN
2
Author Information
1. Department of Gastroenterology, Kashgar Prefecture Second People’s Hospital
2. Department of Digestive Endoscopy, Huadong Hospital Affiliated to Fudan University
- Publication Type:Journal Article
- Keywords:
Acute Non-Variceal Upper Gastrointestinal Bleeding;
Combined Hemostasis;
Conventional Endoscope;
Primary Hospitals
- From:Chinese Journal of Gastroenterology
2022;27(7):410-414
- CountryChina
- Language:Chinese
-
Abstract:
Background: Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common acute and severe clinical entities. As the limited medical resource in remote regions or primary hospitals, it is necessary to explore an effective endoscopic hemostasis method in such a medical condition. Aims: To investigate the efficacy of norepinephrine injection combined with electrocoagulation under conventional endoscopy in patients with ANVUGIB. Methods: Clinical data of 123 ANVUGIB patients were collected retrospectively from January 2019 to December 2021 at the Kashgar Prefecture Second People’s Hospital. According to the endoscopic hemostasis method used initially, these patients were divided into group A (submucosal injection of norepinephrine), group B (electrocoagulation), group C (clip hemostasis) and group D (direct norepinephrine injection combined with electrocoagulation). The success rate of immediate hemostasis, operation time, rebleeding rate within 72 hours, and rate of transfer to surgery were compared between the four groups. Furthermore, the relationship between visual field during hemostasis and success of immediate hemostasis was analyzed. Results: In group D, all patients achieved success immediate hemostasis, the success rate (100%) was significantly higher than that in group A, group B, and group C (all P<0.05). No rebleeding and surgical transfer was observed in group D. The operation time of group D was (17.84±6.78) min, which was not significantly different from that of group A and group C (all P>0.05). In patients treated with combined hemostasis, including initial combination strategy and failed cases transferred to combination strategy, a clear endoscopic visual field could be obtained in 94.2% of the cases, and the success rate of immediate hemostasis was 98.1%. Conclusions: Submucosal injection of norepinephrine combined with electrocoagulation under conventional endoscopy has a higher immediate hemostasis rate with lower rates of rebleeding and surgical transfer in ANVUGIB patients. This strategy is worthy for popularizing in remote regions and primary hospitals.
