Efficacy of four kinds of endoscopic therapy on peptic deer bleeding

Objective To evaluate the efficacy of 4 kinds of endoscopic therapy on peptic ulcer bleeding. Methods Three hundred and forty-nine patients with active ulcer bleeding or non-bleeding visible vessels were respectively divided into 4 groups according to endoscopic therapies (adrenaline injection group, titanic clip placement group, argon beam coagulation group and combined treatment group). One hundred and fifty-seven patients were treated to stop bleeding with injection of adrenaline in adrenaline injection group, 46 with titanic clips in titanic clip placement group, 51 with argon beam coagulation in argon beam coagulation group, and 95 patients with combination of injection and argon beam coagulation in combined treatment group. The hemostasis effects were compared among four groups. Results In all the groups, the immediate hemostasis rate was 100%, and effective hemostasis was achieved in 87.9%, 89.1%,86.3% and 91.6% of the patients who underwent adrenaline injection, titanic clip placement, argon beam coagulation and combined treatment respectively, with no statistical difference among the groups (P>0.05). For patients with Forrest Ⅰ a lesions, the effective hemostasis rate with adrenaline injection (55.0%) was significantly lower as compared with other treatment options (P<0.01). Conclusions Four kinds of endoscopic therapy are effective and safe in patients with peptic ulcer bleeding. Adrenaline injection seems to be a poor solution for Forrest Ⅰ a lesions. Key words: Peptic ulcer hemorrhage; Hemostasis; endoscopic; Epinephrine; Argon ion; Titanic clip