急诊内镜金属夹治疗食管贲门黏膜撕裂出血(附38例报告)  

Emergency endoscopic hemoclip placement for upper gastrointestinal bleeding due to Mallory-Weiss syndrome: A report of 38 cases

作　　者：张宁[1] 江怡怡[2] 董丽丽[1] 于杰[1] 

机构地区：[1]青岛市第三人民医院内镜中心,青岛266041 [2]青岛市市立医院,青岛266011

出　　处：《中国微创外科杂志》2006年第2期95-96,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的观察急诊内镜下金属夹治疗食管贲门黏膜撕裂症（Mallory-Weiss syndrome，MWS）所致的上消化道出血的止血效果和安全性。方法急诊内镜检查确诊MWS出血38例，活动性出血病灶（Forrest Ⅰ）14例和近期出血性病灶（Forrest Ⅱ）24例，在内镜下应用金属夹治疗24h、5d及1-2个月后复查内镜。结果金属夹治疗全部止血成功。手术时间12-40（24±3．6）min。金属夹治疗后无并发症，无再出血，也无死亡病例。内镜随访显示金属夹对组织无损伤，不影响MWS的愈合。1-2个月后复查内镜，30例金属夹已经脱落；8例未脱落，但病灶愈合，患者饮食正常。结论急诊内镜下金属夹治疗MWS引起的上消化道出血是一种非常有效、安全的急诊治疗措施。Objective To observe the efficacy and safety of emergency endoscopic hemoclip placement for the treatment of upper gastrointestinal bleeding due to Mallory-Weiss syndrome （ MWS）. Methods Endoscopic hemoclip placement was conducted in 14 cases of active bleeding （Fon＇est Ⅰ ） and 24 cases of visible vessels or fresh adhesive clots （ Forrest Ⅱ ） , proven to have MWS by endoscopic examinations. Follow-up endoscopy was performed at 24 hours, 5 days, and 1 - 2 months after the procedure, respectively. Results Initial hemostasis was achieved in all patients treated with hemoclips. The operation time was 12-40 rain （mean,24 ± 3. 6 rain）. No complications, recurrent bleeding, or death happened. Follow-up endoscopy showed no evidence of hemoclip-induced tissue injuries or impairment to lesion healing related to hemoclipping. Re-examinations of endoscopy 1 - 2 months after the procedure showed the hemociip shedding in 30 cases and still grasping in. 8 cases （ which had healed lesions and normal diets）. Conclusions Emergency endoscopic hemoclip placement for the treatment of upper gastrointestinal bleeding due to MalloryWeiss syndrome is safe and effective.

关 键 词：金属夹 食道贵门黏膜撕裂症 上消化道出血 急诊内镜 

分 类 号：R655.4[医药卫生—外科学]