Abstract
Objective:To analyze the efficacy of therapeutic endoscopy in combination with quadruple therapy in treating bleeding caused by gastric ulcer and investigate the factors inducing rebleeding.Methods:Two hundred and twelve patients with bleeding caused by gastric ulcer who were admitted to Binzhou People's Hospital, Shandong, China between April 2015 and April 2016 were selected as research subjects. The patients were randomly divided into a control group and an experimental group. Patients in the control group were treated by quadruple therapy, while patients in the observation group received therapeutic endoscopy treatment in addition to the same treatment as the control group. The treatment efficacy, adverse reaction, H pylori (Hp) clearance rate and rebleeding were compared between the two groups.Results:The effective rate of the observation group was 98.1%, which was significantly higher than that of the control group (80.2%), and the difference had statistical significance (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group. The Hp clearance rate of the observation group was higher than that of the control group, and the difference had statistical significance (P<0.05). The multi-factor analysis on rebleeding suggested that whether therapeutic endoscopy was performed or not, hemoglobin level and presence of peptic ulcer stage A1 were independent risk factors.Conclusion:Endoscopic treatment in combination with quadruple therapy is better in the treatment of bleeding caused by gastric ulcer as compared to medical treatment alone. Patients with high-risk factors such as low content of hemoglobin and ulcer at stage A1 should be monitored more carefully to prevent the occurrence of rebleeding.
Highlights
Gastric ulcer is one of the commonly seen digestive system diseases in clinics
This study investigated the efficacy of therapeutic endoscopy in combination with quadruple therapy in the treatment of bleeding gastric ulcer and compared it to medical treatment alone
Rehaemorrhagia: The incidence of rehaemorrhagia of the observation group was 8.5% (9/106), which was lower than 30.2% in the control group (32/106)
Summary
Gastric ulcer is one of the commonly seen digestive system diseases in clinics. With the improvement of living standards and changes in dietary habits, the incidence of gastric ulcer is increasing.[1,2] Singh et al has suggested that gastric ulcer is responsible for 35% of cases with upper digestive tract bleeding.[3] Gastric ulcer induced bleeding is the most common complication for patients with gastric ulcer and one of medical emergency. Rebleeding in patients with gastric ulcer bleeding can decrease the survival rate of patients.[4] If treatment is delayed, the life of patients will be severely threatened. It is important to select a scientific treatment for patients with gastric ulcer induced bleeding
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