急诊内镜下硬化治疗在急性非门脉高压症消化道大出血中的应用价值  

Emergency endoscopy and sclerotherapy in treatment of non-portal hypertension gastrointestinal bleeding

作　　者：宋刘来[1] 钟良[1] 陈爱武[1] 罗和生[1] 

机构地区：[1]浙江省台州市立医院消化内科,浙江台州318000

出　　处：《中国内镜杂志》2011年第3期292-293,297,共3页China Journal of Endoscopy

摘　　要：目的探讨急诊内镜下硬化治疗术在急性非门脉高压症消化道大出血中的临床应用价值,并评估其安全性。方法对近6年来47例急性非门脉高压症消化道大出血患者,包括食管贲门黏膜撕裂合并大出血2例,胃、十二指肠溃疡伴血管裸露合并大出血32例,胃十二指肠恒径动脉畸形(杜氏病)合并大出血9例,结、直肠血管畸形伴大出血4例,行急诊内镜检查明确出血部位,并于出血病灶周围注射肾上腺素及硬化剂(鱼肝油酸钠或乙氧硬化醇)止血,观察其疗效及并发症。结果全部病例经治疗后均基本止血,内镜治疗后经过药物治疗1～2个月复查内镜42例达到临床痊愈,5例出现继发性溃疡,均经药物治疗后痊愈。结论急诊内镜下硬化治疗术治疗急性消化道大出血具有止血效果确实可靠、创伤小、风险可控等优点,值得推广。Objective To evaluate the safety and efficacy of endoscopic sclerotherapy in treatment of non-portal hypertension gastrointestinal bleeding.Methods In recent 6 years 47 cases of non-portal hypertension acute gastrointestinal bleeding,including 2 cases of Mallory-Weiss syndrome,32 peptic ulcer cases with exposed vessels,9 Dieulafoy＇Disease,4 cases of colonic vascular malformation,were taken emergency endoscopy.The injection of adrenaline and sclerosing agent were injected around bleeding lesions.Results All cases stopped bleeding after treatment.42 cases were healed after 1～2 months of medication.5 cases had peptic ulcer.Conclusion Sclerotherapy has significant effects in treatment of non-portal hypertension gastrointestinal bleeding.

关 键 词：急诊内镜检查 硬化治疗术 非门脉高压症 急性消化道大出血 

分 类 号：R57[医药卫生—消化系统]