食管-贲门黏膜撕裂综合征诊断与治疗  

Diagnosis and treatment of Mallory-Weiss syndrome

作　　者：娄重阳 李德宇[1] 王连才[1] 田广金[1] 穆森茂 肖二卫 

机构地区：[1]郑州大学人民医院河南省人民医院肝胆胰腺外科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2016年第6期604-605,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省基础研究项目(122300410065)

摘　　要：目的探讨食管-贲门黏膜撕裂综合征(Mallory-Weiss综合征)的临床特点、诊断和治疗方法。方法回顾性分析101例Mallory-Weiss综合征患者的临床资料,比较保守治疗患者和内镜治疗患者的诱因、住院时间、输血量和再出血发生率等。结果 46例患者接受保守治疗(保守组),其中31例一期治愈,15例经保守治疗后再出血经内镜治疗治愈;51例患者经内镜治疗一期治愈(内镜组);4例手术治疗,其中3例治愈,1例死亡;Mallory-Weiss综合征占同期上消化道出血的7.79%,剧烈呕吐是主要诱因,上消化道出血是主要症状,急诊内镜是主要检查方法;内镜组住院时间[(7.1±1.5)d]、输血量[(296.1±99.4)mL]和再出血发生率(0)均低于保守组[(11.8±2.3)d、(652.2±196.1)mL、32.6%](P<0.05),性别比例、年龄、诱因和病死率与保守组比较差异均无统计学意义(P>0.05)。结论 Mallory-Weiss综合征以呕吐后消化道出血为主要临床特点,急诊内镜是主要检查治疗方法。Objective To investigate the clinical features,diagnosis and treatment of Mallory-Weiss syndrome（MWS）.Methods The clinical data of 101 patients with MWS were collected and retrospectively analyzed to compare the causes,hospitalization stay,blood transfusion volume and rebleeding rate in the patients receiving conservative treatment and endoscopic treatment.Results In 46 patients receiving conservation treatment,31 patients were cured at one stage,and15 patients with secondary bleeding after conservative treatment were cured after endoscopic treatment.Another 51 patients receiving endoscopic treatment were cured at one stage.In 4patients underwent operation,3were cured and 1died.MWS accounted for 7.79% of patients with upper gastrointestinal bleeding,with the main cause of vomiting,and the main symptom of upper gastrointestinal bleeding.Emergency endoscopy was the main diagnostic method.The hospitalization stay（（7.1±1.5）d）was shorter,blood transfusion volume（（496.1±99.4）mL）was less and rebleeding incidence（0）was lower in the patients receiving endoscopic treatment than those in the patients receiving conservative treatment（（11.8±2.3）d,（952.2±196.1）mL,32.6%）（P〈0.01）.There were no significant differences in the gender,age,cause and fatality between two methods（P〈0.05）.Conclusion Gastrointestinal bleeding after vomiting is the main clinical characteristic of MWS,and emergency endoscopy is the main diagnotic method and the first choice of treatment.

关 键 词：MALLORY-WEISS综合征 急诊内镜 消化道出血 

分 类 号：R57[医药卫生—消化系统]