内镜下止血夹治疗在急性非静脉曲张性消化道出血中的应用

The Hemostatic Efficacy for Hemoclips Therapy in Treating Acute Non-Variceal Gastrointestinal Tract Bleeding

目的观察内镜下金属止血夹治疗急性非静脉曲张消化道出血的治疗效果。方法收集我院2004年7月至2009年7月收治的急性非静脉曲张消化道出血患者79例,在内镜下明确出血部位,使用止血夹钳夹止血。结果 79例急性非静脉曲张消化道出血患者应用内镜下金属止血夹止血治疗,共用金属夹238枚,平均每例3.01枚,即时止血率97.47%(77/79),20例止血夹止血失败病例中1例Dieulafoy病患者改用内镜下套扎治疗止血成功,另1例转外科手术治疗。1周内再出血率3.80%(3/79),其中2例患者转手术治疗。所有患者内镜术后均未出现内镜治疗相关并发症,全组无死亡病例。结论内镜下金属止血夹是一种治疗急性非静脉曲张消化道出血的有效方法,具有操作简单,止血效率高及无明显并发症等优点,值得临床推广应用。

Objective To oboserve the therapeutic effect of hemoclips therapy in treating acute non-variceal gastrointestinal tract bleeding.Methods Date on 79 cases of acute non-variceal gastrointestinal tract bleeding,treated between July 2004 and July 2009 were collected.The bleeding site was identified by endoscope,and both ends of the bleeding area were clipped with hemoclips adjuster.Results There were 238 clips in 79 cases and 3.01 in average.Initial hemostasis with clips was achieved in 77 patients（77/79）.One case of Dieulafoy’s disease arrested bleeding with band ligation and the patient of Mallory-Weiss syndrome underwent emergency surgery.Bleeding recurred in 3 patients within one week in the group（3.80%） and 2 of them underwent emergency surgery to arrest bleeding.There were no complications related to endoscopic therapy.Conclusion Metal hemoclips provide an effective and easy measure with which to treat acute non-variceal gastrointestinal tract bleeding.They offer better efficacy than hemostasis treatment without any severe complications and their widespread clinical application is recommended.