覆膜金属支架在经内镜乳头括约肌切开术难治性出血中的应用  

Covered self-expandable metal stent for uncontrolled bleeding after endoscopic sphincterotomy

作　　者：吴军[1] 胡冰[1] 

机构地区：[1]第二军医大学东方肝胆外科医院内镜中心,上海200438

出　　处：《中华消化内镜杂志》2012年第4期194-196,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨覆膜金属支架在内镜下十二指肠乳头括约肌切开术（EST）无法控制的出血中的应用价值。方法回顾性分析2000年1月以来的资料，11年间共开展EST3460例，发生出血29例（0．84％）。其中4例患者在采用常规方法无法止血后，跨乳头释放全覆膜金属支架进行压迫止血。结果4例患者均顺利放置覆膜金属支架并成功止血。1例支架留置1周后顺利拔除；1例支架于4周内自行脱落；2例患者拒绝拔除支架，通畅时间大于6个月和12个月。放置及拔除支架过程中均未发生并发症。结论对于EST无法控制的出血，放置覆膜金属支架是安全、有效、简便的止血方法。Objective To investigate the role of temporary placement of fully covered self-expandable metal stent （ eSEMS ） for treatment of uncontrolled bleeding after endoscopic sphineterotomy （EST）. Methods From January 2000 to present, a total of 3460 cases of EST were performed, and bleeding after the procedure was complicated in 29 （0. 84% ） of them, in which 4 could not to be stopped by conventional managements. Covered SEMSs were placed across the major papilla in these 4 patients. Results The stents were successfully placed and hemostasis was achieved in all patients. The stent was removed in 1 patient 1 week later, and spontaneous stent dislodgment occurred in 1 patient within 4 weeks. The other ：2 patients rejected to remove the stents, and the patency maintained for more than 6 and 12 months respectively. No complication was observed in procedures of placing and removing stents. Conclusion Covered SEMS placement is a safe, effective and simple method for patients with uncontrolled bleeding after EST.

关 键 词：内窥镜括约肌切开术 止血 内窥镜 自膨式覆膜金属支架 

分 类 号：R656.6[医药卫生—外科学]