内镜下注射与钛夹联合治疗食管贲门黏膜撕裂综合征出血的临床研究

Application of endoscopic hemoclips and local injection in Mallory-Weiss syndrome with hemorrhage

目的探讨内镜下金属钛夹与注射联合应用在食管贲门黏膜撕裂综合征出血患者中的治疗价值。方法对我科2005年1月~2010年1月所诊治的83例食管贲门黏膜撕裂综合征（MWS）出血患者进行随机分组,A组行内镜下注射＋金属钛夹治疗,B组单纯行内镜下金属钛夹治疗。分析两组治疗时间、止血效果和再出血等方面的差异。结果 A组患者平均治疗时间12.6 min;B组患者平均治疗时间15.2 min。83例患者经两种方法治疗后,均可立即止血。A组无再次出血患者,B组2例患者再出血。结论内镜下注射＋金属钛夹联合治疗食管贲门黏膜撕裂出血具有止血效果确实可靠、定位准确和操作简便等优点,可作为食管贲门黏膜裂出血的首选治疗。

Objective To investigate the value of local injection and endoscopic hemoclips in Mallory-Weiss syndrome（MWS） with hemorrhage.Methods Eighty-three MWS patients were randomly divided into two groups： group A treated with local injection and endoscopic hemoclips;group B treated with endoscopic hemoclips.Therapeutic time,homeostatic effect and rebleeding were compared between two groups.Results The average treatment time were 12.6 min in group A and 15.2 min in group B.After treatment,all patients bleeding were stopped immediately.There was no one rebleeding in group A.There were two patients with rebleeding in group B.Conclusion Local injection combined with endoscopic hemoclips is an accurate positioning,effective and safe method for Mallory-Weiss syndrome with hemorrhage.