急诊内镜治疗上消化道动脉性出血

Emergency Endoscopic Treatment for Upper Gastrointestinal Arterial Hemorrhage

目的 评价上消化道动脉性出血的内镜治疗效果。 方法 回顾性总结1998年以来收治的31例上消化道动脉性出血的临床资料,所有病人均实行急诊内镜下1∶10 000肾上腺素盐水注射治疗。 结果 本组内镜止血有效29例(93. 5% ),其中2例治疗过程中再次出现搏动性出血,经继续内镜下治疗止血成功; 3例止血后再出血,经再次胃镜下注射后止血。止血失败2例( 6. 5% ),经BillrothⅠ式胃大部切除后治愈。10例治疗过程中出现胸痛或腹痛, 9例自行缓解, 1例给予镇痛剂后缓解,无其他并发症。 结论 内镜下注射肾上腺素治疗上消化道动脉性出血方法简单、疗效可靠、安全性高,可成为目前首选的治疗方法。

Objective To assess the emergency endoscopic treatment for upper gastrointestinal arterial hemorrhage. Method 31 cases of upper intestinal arterial hemorrhage underwent emergency endoscopic treatment with 1∶10 000 Epinephrine saline. Result Hemostasis achieved in 29 cases (93.5%)of which implusive bleeding persisted in 2 cases and was eventually controlled by repeated injection. Recurrence of bleeding was found in 3 cases and retreated endoscopically. 2 cases underwent Billroth Ⅰ subtotal gastrectomy due to uncontrollable hemorrhage. Chest pain and abdominal pain occured in 10 cases, of which 9 cases relieved spontenously and 1 case had to be treated with analgetic. Conclusion Endoscopic injection of Epinephrine presents a simple, effective and low-risk solution for upper gastrointestinal arterial bleeding.