急性非静脉曲张性上消化道出血常规内镜下止血后再出血的血管栓塞术治疗价值  

Vascular embolization for acute non-variceal upper gastrointestinal rebleeding after conventional endoscopic hemostasis

作　　者：肖梅 贾勇 郑邦海 陈思 许朝 王慧群 Xiao Mei;Jia Yong;Zheng Banghai;Chen Si;Xu Chao;Wang Huiqun(Department of Gastroenterology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院消化内科,合肥230001

出　　处：《中华消化内镜杂志》2022年第7期575-578,共4页Chinese Journal of Digestive Endoscopy

摘　　要：2017年4月—2020年6月,因急性非静脉曲张性上消化道出血(acute non-variceal upper gastrointestinal bleeding,ANVUGIB)行内镜下止血治疗(包括局部注射药物、电凝、止血夹和套扎等)后再出血,于中国科学技术大学附属第一医院消化内科接受内镜下血管栓塞术(endoscopic vascular embolization,EVE)治疗的病例共46例。46例经EVE治疗后均即刻止血,即刻止血有效率为100.0%。术后出现腹痛13例(28.3%),腹胀3例(6.5%),发热2例(4.3%)。术后3、12个月复查胃镜,黏膜逐渐愈合。随访至2021年6月,无一例消化道再出血发生。由此可见,EVE对于初次内镜止血失败的ANVUGIB患者是一种安全、高效的方法,值得临床进一步研究和推广应用。From April 2017 to June 2020,46 patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB)underwent endoscopic vascular embolization(EVE)in the Department of Gastroenterology of the First Affiliated Hospital of University of Science and Technology of China for rebleeding after endoscopic hemostasis therapy(including local drug injection,electrocoagulation,hemostatic clamp and ligation,etc.).All 46 patients immediately stopped bleeding after EVE,and the effective rate of immediate hemostasis was 100.0%.Postoperative abdominal pain occurred in 13 cases(28.3%),abdominal distension in 3 cases(6.5%)and fever in 2 cases(4.3%).The mucosa healed gradually under gastroscopy 3 and 12 months after the operation.No gastrointestinal rebleeding occurred during the follow-up.Therefore,EVE is a safe and effective method for ANVUGIB patients with failure of initial endoscopic hemostasis,which is worthy of further clinical study and application.

关 键 词：止血 内窥镜 急性非静脉曲张性上消化道出血 再出血 内镜下血管栓塞术 

分 类 号：R573.2[医药卫生—消化系统]