Retrospective analysis of clinical efficacy and influencing factors of over-the-scope-clip system in the treatment of refractory peptic ulcer bleeding in active stage
MAO Xu-yan
WANG Wen-hai
SUN Xiu-jing
CHU Rui
LI Peng
Abstract：Objective To retrospectively analyze the clinical efficacy and influencing factors of OTSC system in the treatment of acute active refractory peptic ulcer bleeding.Methods The data of patients with acute active refractory upper gastrointestinal ulcer bleeding admitted to Beijing Friendship Hospital January 2016 to January 2024 were collected for hemostasis using OTSC system and routine tissue clips,and the analysis indicators were the success rate of timely hemostasis during surgery,the time of hemostasis,and the rate of re-bleeding within 7 days.According to the postoperative recurrence of bleeding,and univariate and multivariate logistic regression were used to analyze the influencing factors of the failure of OTSC anastomosis clip hemostasis.Results In the OTSC group,39 cases had successful intraoperative hemostasis under endoscopy,with an average hemostasis time of(11.25±4.28)min,and 42 cases in the conventional tissue clipping group,34 cases had successful intraoperative hemostasis,with an average hemostasis time of(15.07±6.79)min.The success rate of intraoperative immediate hemostasis in the OTSC group was significantly higher than that in the tissue clip group,and the intraoperative hemostasis time in the OTSC group was significantly lower than that in the tissue clip group,P＜0.05,the difference was statistically significant,and there was no significant difference in the blood rate in the OTSC group within 7 days after surgery,7 cases in the conventional tissue clip group within 7 days after surgery,and the blood rate in the OTSC group and the tissue clip group within 7 days,P＞0.05.The results of logistic regression analysis of hemostasis failure in the OTSC group showed that Forrest grade Ⅰ a and ulcer size ≥1.5 cm were the influencing factors for OTSC treatment failure(P＜0.05),and the risk degree was Forrest grade Ⅰ a(OR=24.097)and ulcer size ≥ 1.5 cm(OR=17.036).Conclusion OTSC is a rapid and effective method of hemostasis in the treatment of refractory active peptic ulcer bleeding with high success rate and short hemostatic time,but OTSC does not significantly reduce the rebleeding rate within 7 days,ulcer size ≥1.5 cm,ulcer bleeding Forrest grade Ⅰ a may be risk factors affecting the failure of OTSC anastomosis clip hemostasis,and scientific and reasonable hemostatic measures should be formulated according to the specific situation of patients.
Keywords：refractoryupper peptic ulcer bleedingover-the-scope-clipinfluencing factors
Publication Date：2025-01-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 62-66 )