应用组织粘合剂三明治注射法治疗Dieulafoy病出血的对照研究

Control study of tissue adhesive sandwich injection in treatment of Dieulafoy’s disease bleeding

目的:评价内镜下应用组织粘合剂三明治注射法治疗Dieulafoy病出血的治疗效果。方法:将61例Dieulafoy病大出血患者随机分为A组和B组,A组31例、B组27例。A组予内镜下组织粘合剂三明治注射法止血,B组予内镜下高频电凝止血钳法止血。治疗后比较两组止血成功率、术后72 h内再出血率,同时观察术后有无异位栓塞、组织坏死等并发症。结果:两组止血率无统计学差异(P>0.05),但B组72 h再出血率明显高于A组,差异有统计学意义(P<0.05)。结论:组织粘合剂三明治注射法是Dieulafoy病胃镜止血的快速、有效、安全的治疗手段。

Objective:To evaluate the treatment effect of endoscopic application of tissue adhesive sandwich injection in treatment of Dieulafoy’s disease bleeding.Methods:A total of 61 patients with massive bleeding due to Dieulafoy’s disease were randomly divided into group A and group B,with 31 cases in group A and 27 cases in group B.Group A was given endoscopic cyanoacrylate sandwich injection for hemostasis,and group B was given endoscopic high-frequency electrocoagulation hemostatic forceps for hemostasis.After treatment,the success rate of hemostasis and the rate of rebleeding within 72 hours after operation were compared between the two groups.At the same time,the postoperative complications such as ectopic embolism and tissue necrosis were observed.Results:There was no statistical difference in the hemostatic rate between the two groups(P>0.05),but the 72-hour rebleeding rate in group B was significantly higher than that in group A,and the difference was statistically significant(P<0.05).Conclusions:Tissue adhesive sandwich injection is a fast,effective and safe treatment for gastroscopic hemostasis in Dieulafoy’s disease.