内镜下夹子治疗和预防消化道出血的研究

Endoscopic clipping for checking and preventing GI bleeding:A primary study

目的本文探讨经内镜金属夹治疗和预防消化道出血的应用技术及影响疗效因素。方法选用ＯｌｙｍｐｕｓＭＨ８５８和ＭＤ８５０型内镜金属夹；夹与靶之间的角度应为９０度。结果３８例消化道出血中，止血＞７２小时３４例，＜７２小时４例。出血复发原因与溃疡部位、大小、深度和溃疡基部血管显露直接相关：在７例息肉切除和４例粘膜切除前后应用金属夹，可避免出血、人工溃疡形成和穿孔。结论内镜金属夹为治疗内镜提供了一种安全、有效和简便的方法。

Objective This paper deals with the techniques in applying endoscopic clips for checking and preventing GI bleeding and its effect influencing factors.Methods 53 patients with bleeding from focus or wound after interventional endoscopy underwent the study.Olympus,type MH858 or MD850,endoscopic clips were adopted,being applied at right angle to the focus to ensure hemostatic effect.Results Hemostasis after clipping lasted over 72 hours was recoded in 34/38 cases,less than 72 hours in 4;the cause of rebleeding from the very focus was probably related with the location,size and depth of ulcer as well as the number and calibre of vessels exposed in wound.CONCLUSION The clipping brings about an endoscopic and effective means to check and prevent GI bleeding.