A RANDOMIZED STUDY OF INJECTION-HEMOCLIPPING COMPARED TO INJECTION-MULTIPOLAR

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 具体目标 1.比较非静脉曲张、非恶性或非血管瘤性结肠出血两种内窥镜联合止血方法(肾上腺素注射加多极探针法或夹闭法)的疗效和安全性。 2.比较结肠镜检查和乙状结肠镜检查(如果是远端结肠检查)3周时病变较基线明显缩小的比例。 3.量化和比较内窥镜治疗前和治疗后即刻的内窥镜病变大小(直径和深度)；在内窥镜治疗前和结肠镜(或柔性乙状结肠镜)检查前3周进行比较。 4.量化和比较两种不同治疗方法在内窥镜下止血后的常规结果，包括初次止血率和永久性止血率；治疗失败率和转用其他治疗方法的比率(急性止血失败、需要重新治疗的严重再出血或严重治疗并发症)；输血(单位红细胞、血小板和新鲜冰冻血浆-总的和随机后的)；住院和重症监护病房的时间；并发症；手术；以及随机分组后7天和30天的死亡率。 5.估计和比较患者随机分组后的直接护理成本。 6.为出版和教学目的，记录、编辑和存档研究案例的数字图像和视频剪辑。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. SPECIFIC AIMS 1. To compare the efficacy and safety of two endoscopic combination therapies (epinephrine injection plus either multipolar probe or hemoclipping) for hemostasis of non-variceal, non-malignant, or non-angiomatous colonic hemorrhage. 2. To compare the proportion of lesions with a significant decrease in size from baseline at 3 weeks colonoscopy or flexible sigmoidoscopy (if in distal colon). 3. To quantitate and compare endoscopic lesion sizes (diameter and depth) before vs. immediately after endoscopic treatments; and before endoscopic treatment vs. 3 weeks on colonoscopy (or flexible sigmoidoscopy). 4. To quantitate and compare routine outcomes after endoscopic hemostasis with the two different treatments, including primary and permanent hemostasis rates; rates of treatment failure and crossover to the other treatment (for failure of acute hemostasis, severe rebleeding necessitating retreatment, or a severe treatment complication); transfusions (units red blood cells, platelets, and fresh frozen plasma- total and post-randomization); duration of hospital and intensive care unit stay; complications; surgery; and mortality rates at 7 and 30 days after randomization. 5. To estimate and compare direct costs of care, after randomization of patients. 6. To record, edit, and archive digital images and videoclips of study cases for publication and teaching purposes.