内镜下钛夹联合肾上腺素注射治疗上消化道Dieulafoy病活动性出血的临床疗效研究  

作　　者：孟凡军[1] 刘晓波[1] 孙勇[1] 王太斌[1] 张宇飞[1] 刘震雄[2] 

机构地区：[1]辽宁沈阳中国人民解放军第202医院消化内科,110812 [2]陕西西安中国人民解放军第四军医大学唐都医院消化内科,710038

出　　处：《浙江临床医学》2016年第8期1419-1420,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨内镜下金属钛夹联合注射肾上腺素治疗上消化道Dieulafoy病活动性出血的临床疗效并评价其安全性。方法选择2010年1月至2015年1月有活动性上消化道出血的Dieulafoy病患者，采用内镜下金属钛夹钳夹联合黏膜下注射1：10000肾上腺素进行止血治疗，评估其止血的临床效果及相关并发症情况。结果本组48例Dieulafoy病患者经过内镜下治疗后，全部出血立即停止，即时止血率为100％。2例再次出血行二次治疗，其中1例转外科手术。所有患者术后均未出现消化道穿孔、感染、发热以及栓塞等并发症，术后随访3个月，未见再出血病例。结论内镜下钛夹钳夹联合肾上腺素注射是治疗Dieulafoy病出血的一种有效措施，其操作简易、止血效果确切，术后恢复良好，并发症少，值得临床推广与运用。Objective To evaluate the clinical efficacy and safety of endoscopic titanium clip combined with local epinephrine injection to treat bleeding Dieulafoy disease on upper digestive tract. Methods 48 Dieulafoy disease on Upper Digestive Tract with acute bleeding were treated by endoscopic titanium clip combined with local epinephrine （ 1 ： 10 000 ） injection. Then, evaluate the effect of hemostasis and the occurrence of complications related complications. Results After endoscopic treatment, all patients stopped bleeding immediately （ 100% ） . Two cases （ 0.042 % ） were conducted second time. One case stopped bleeding, but another case were transformed to surgical department for surgical operation because of lacking effect. All patients have not any complications such as gastrointestinal perforation, infection, fever and embolism after treatment. Followed up of 3 months, no hemorrhage cases appeared. Conclusion Endoscopic titanium clip combined with local epinephrine injection is a kind of effective measure for treatment of Dieulafoy disease. Because it is easy to operate, fewer complications, hemostatic effect and postoperative recovery is excellent, it is worthy of clinical promotion and application.

关 键 词：DIEULAFOY病 内镜 上消化道出血 钛夹 肾上腺素 

分 类 号：R573.2[医药卫生—消化系统]