内镜下老年人消化道非静脉曲张破裂出血常见病因及治疗  

Common causes and endoscopic treatment of elderly non-variceal gastrointestinal hemorrhage

作　　者：张帆 罗志刚[2] 聂静[2] 张茶丽[2] 

机构地区：[1]云南省第三人民医院消化内科,云南昆明650011 [2]昆明市第一人民医院消化内科,云南昆明650034

出　　处：《云南医药》2014年第2期131-134,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的探讨镜下所见消化道出血常见病因及治疗方法。方法对2009年3月～2013年10月昆明市第一人民医院内镜检查所见老年人消化道出血52例病例资料进行回顾性分析。结果52例老年患者发现镜下出血,胃溃疡占30.77%（16/52）,十二指肠溃疡占25%（13/52）,贲门溃疡2例,贲门黏膜撕裂4例,Dieulafoy病6例,吻合口溃疡3例,活检术后2例,息肉切除术后4例,肠道不明原因渗血2例。52例均行镜下治疗,镜下即时止血成功率92.31%（48/52）,所有病例均无穿孔及其他术后并发症。结论镜检所见老年人消化道出血最常见病因为消化性溃疡,镜下治疗以金属钛夹止血为主,其特点是创伤小,急诊止血率高,病死率低,并发症少,已成为主要的治疗方法,值得临床推广。Objective To discuss the common causes and endoscopic treatment of gastrointestinal hemorrhage.Methods To analyze retrospectively 52 cases of elderly gastrointestinal hemorrhage by endoscopic examination in the First People＇s Hospital of Kunming from March,2009 to October,2013. Results 52 cases of elderly patients were found to have endoscopic hemorrhage, among which stomach ulcer cases accounted for 30.77%（16/52）,duodenal ulcer cases accounted for 25%（13/52）, and there were 2 cases of cardia ulcer,4 cases of cardia Weiss,6 cases of Dieulafoy,3cases of anastomotic ulcer,2 cases after operation of biopsy,4 cases after operation of polypectomy,and 2 cases of unexplained intestinalbleeding.Allthe52 casesunderwentendoscopictreatment,and thehemostaticsuccessratewere92.31%（48/52）.All the cases had no perforation and other postoperative complications.Conclusion The most common cause of elderly gastrointestinal hemorrhage found by endoscopic examination is peptic ulcer.Metal titanium clamp combined with hemostatic treatment is the main endoscopic treatment,which accounts for 90.38%（47/52）and the immediate hemostasis rate are 91.49%（43/47）.Because it is characterized by less trauma,high emergency hemostasis rate,low mortality rate,and fewer complications,it should be the main therapy which deserves clinical promotion.

关 键 词：急性非静脉曲张性消化道出血 金属钛夹 镜下治疗 

分 类 号：R573[医药卫生—消化系统]