内镜下组织胶注射治疗难治性急性非静脉曲张上消化道出血的应用进展  

Application Progress of Endoscopic Tissue Glue Injection in the Treatment of Refractory Acute Non-variceal Upper Gastrointestinal Bleeding

作　　者：沈林艳 陈明 杨景毅 冯丽平 唐忠银 王声 龚璇 唐婷 黄海荣 SHEN Linyan;CHEN Ming;YANG Jingyi;FENG Liping;TANG Zhongyin;WANG Sheng;GONG Xuan;TANG Ting;HUANG Hairong(Department of Gastroenterology,Guilin Hospital of Integrated Traditional Chinese and Western Medicine,Guilin,Guangxi Zhuang Autonomous Region,541004 China)

机构地区：[1]桂林市中西医结合医院消化内科,广西桂林541004

出　　处：《系统医学》2023年第8期193-198,共6页Systems Medicine

基　　金：广西科技计划项目广西重点研发计划基金项目(桂科AB22035076);广西壮族自治区中医药管理局自筹基金项目(GZZC2020291);桂林市科学技术局基金项目(2020011210-2)。

摘　　要：难治性急性非静脉曲张性上消化道出血是消化内科棘手的急危重症之一,24 h内急诊内镜止血是首选治疗方法,内镜止血方法包括药物局部喷洒和注射、热凝、机械止血,即使内镜下多种方法联合,对于难治性出血病灶仍存在止血困难和再出血的风险。随着近年组织胶注射在胃底静脉曲张治疗中的广泛应用并取得良好效果,部分内镜医生也开始研究组织胶在非静脉曲张性上消化道出血中的应用,并取得了满意疗效,但由于对适应证及注射方法的争议、排胶及异位栓塞等并发症的担心,导致该技术的应用和报道仍为数不多。主要对内镜下组织胶注射治疗难治性急性非静脉曲张性上消化道出血进行综述,为内镜下组织胶注射治疗难治性急性非静脉曲张性上消化道出血的有效性和安全性提供有价值的参考。Refractory acute non-variceal upper gastrointestinal bleeding is one of the difficult emergencies in gastroenterology,and emergency endoscopic hemostasis within 24 hours is the preferred treatment.Endoscopic hemostasis methods include local spraying and injection of drugs,thermal coagulation,and mechanical hemostasis.Even if multiple methods are combined under endoscopy,there are still difficulties in hemostasis and the risk of rebleeding for refractory bleeding lesions.With the widespread application of tissue glue injection in the treatment of gastric varices and good results in recent years,some endoscopists have also begun to study the application of tissue glue in the treatment of non-variceal upper gastrointestinal bleeding,and achieved satisfactory results.However,due to the controversy over indications and injection methods,concerns about complications such as degumming and ectopic embolism,the application and reports of this technique are still few.This paper mainly reviews the treatment of refractory acute non-variceal upper gastrointestinal bleeding by endoscopic tissue glue injection.To provide a valuable reference for the efficacy and safety of endoscopic tissue glue injection in the treatment of refractory acute non-variceal upper gastrointestinal bleeding.

关 键 词：上消化道出血 非静脉曲张 内镜 组织胶 进展 

分 类 号：R4[医药卫生—临床医学]