Abstract:

Objective To evaluate the efficacy of endoscopic metal hemostatic clip combined with esome⁃ prazole in the treatment of Forrest Ⅱb acute non⁃variceal upper gastrointestinal bleeding（NVOGIB），and analyze the economic benefit of the combined therapy. Methods The clinical data of 48 patients with Forrest Ⅱb NVOGIB who were treated with endoscopic metal hemostatic clip combined with esomeprazole were retrospectively analyzed （combined group），and 48 patients with Forrest Ⅱb NVOGIB by a 1：1 match of baseline data such as gender and age treated with someprazole were selected as control group. Clinical efficacy，disease outcomes（blood transfusion rate，hospital stay，7⁃day re⁃bleeding rate）and occurrence of adverse reactions were recorded in the two groups. The mucosal healing status（reproductive mucosal maturity and histological reproductive mucosal maturity）were compared between the two groups after 1 month of treatment. The cost ⁃effectiveness analysis of the two treatment regimens was performed. Results The clinical efficacy of the combined group was significantly higher than that of the control group（P < 0.05），and the hospital stay was significantly shorter than that of control group（P < 0.05）. There were no statistical differences in blood transfusion rate，7⁃day re⁃bleeding rate and occurrence of adverse reactions between the two groups（P > 0.05）. After 1 month of treatment，the reproductive mucosal maturity and histological regenerative mucosal maturity of combined group were better than those of the control group（P < 0.05）. There was higher cost in the combined group（P < 0.05），but the cost⁃effectiveness ratio of 91.45 in combined group was lower than that of 97.07 in the control group. The total effective rate of treatment for every additional unit in the control group needed increased cost of 52.15 yuan compared to combined group. Conclusion Endoscopic metal hemostatic clip combined with esomeprazole has a significant effect in the treatment of Forrest Ⅱb NVOGIB，and it is safe and more economical.

Key words:

acute non ?variceal upper gastrointestinal bleeding, Forrest Ⅱb, endoscopic, metal hemostatic clip, esomeprazole, economic benefit