内镜下医用胶喷洒预防双联抗血小板药物治疗者上消化道早癌内镜黏膜下剥离术迟发性出血的疗效观察  

Curative effection of endoscopic medical glue spraying in prevention of delayed bleeding from endoscopic submucosal dissection of patients with dual antiplatelet

作　　者：胡柯峰[1] 叶国良[1] 金燕平[1] 秦丽君[1] 

机构地区：[1]宁波大学医学院附属医院消化内科,浙江宁波315020

出　　处：《中国中西医结合消化杂志》2017年第3期226-229,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：宁波市科技惠民项目(No:2016C51015)

摘　　要：[目的]评价双联抗血小板药物(阿司匹林和氯吡格雷)服用者上消化道早癌及癌前病变内镜黏膜下剥离术(ESD)后,对创面喷洒医用组织胶预防迟发性出血的安全性及疗效。[方法]选取2015年1月~2016年10月在我院因上消化道早癌及癌前病变行ESD术,同时因合并心脑血管疾病而服用双联抗血小板药物的患者共17例,术前5d停用双联抗血小板药物,对ESD创面常规APC、止血钳及钛夹止血后,再喷洒医用胶,术后24h服用双联抗血小板药物,分析迟发性出血及心脑血管不良事件发生率。[结果]ESD术后72h、7d及30d内迟发性出血0例,无心脑血管不良事件发生。[结论]内镜下医用胶喷洒预防双联抗血小板治疗患者ESD术后迟发性出血疗效确切、操作简单、安全性高,尚需大样本前瞻性研究进一步证实。[Objective] To evaluate the efficacy and feasibility of endoscopic medical glue spraying in prevention of delayed bleeding from endoscopic submucosal dissection（ESD） of patients with dual anti- platelet. [Methods]The clinical data of 17 patients diagnosed with upper gastrointestinal early cancers or precancerous lesions who received ESD,accompany with dual antiplatelet due to cardia-cerebrovaseular dis- ease in our department from January 2015 to October 2016 were analyzed. Medical glue spraying after wound hemostasis using APC, forceps or clips. These patients took dual antiplatelet medications 24 hours after ESD. Delayed bleeding and cardia-cerebrovascular complications were monitored for 72 hours, 7 days and 30 days after treatment. [Results]All the 17 patients underwent ESD successfully. No delayed bleeding happened,no cardia-cerebrovascular complications related to endoscopy occurred. [Conclusion]Endoscopic medical glue spraying in prevention of delayed bleeding from ESD of patients with dual antiplatelet is effec- tive, safe, and simple.

关 键 词：内镜 医用胶 内镜黏膜下剥离术 双联抗血小板治疗 迟发性出血 

分 类 号：R57[医药卫生—消化系统]