内镜下金属钛夹治疗急性非静脉曲张性上消化道出血

Endoscopic titanium clip in treatment of acute non-variceal gastrointestinal bleeding

目的观察内镜下金属钛夹治疗非静脉曲张性上消化道出血的疗效。方法收集2009年5月至2011年5月非静脉曲张性上消化道出血患者60例,均行急诊胃镜检查,在内镜直视下明确出血部位,使用钛夹推送器对准出血部位两端,钳夹出血血管及附近组织,并用0.9%氯化钠注射液局部喷洒冲洗,确认完全止血。结果 60例患者每例使用2～5枚,共使用钛夹176枚,平均患者使用2.9枚。60例患者(100%)治疗时出血即时停止,72h未再出血。均1次止血成功。透视及胃镜术后定期随访,观察钛夹脱落及出血情况。本组未出现1例并发症,钛夹脱落时间为5～58 d,平均23 d。结论内镜下金属钛夹治疗非静脉曲张性上消化道出血是一种安全有效、操作简单、无明显并发症、止血效果显著、费用低的治疗措施,值得大力推广应用。

Objective To observe the endoscopic treatment of titanium clip non-variceal upper gastrointestinal bleeding.Methods Our hospital from May 2009 to May 2011 non-variceal upper gastrointestinal bleeding 60 patients underwent emergency endoscopy,the endoscope clear bleeding site,the use of titanium clips push device potential bleeding sites at both ends,clamp the bleeding vessel and surrounding tissue,and 0.9% sodium chloride injection with local spray wash,to confirm complete hemostasis.Results A total of 60 patients with titanium clip 176,each patient 2 to 5 with an average use of 2.9.Treatment of bleeding immediately stopped 60 cases（100%）,bleeding times were a success.72 hours no further bleeding.Regular postoperative follow-up endoscopy and fluoroscopy to observe the bleeding and titanium clip off situation.The group of titanium clip off time is 5 to 58 days,an average of 23 days,no one case of complications.Conclusions Endoscopic treatment of titanium clip non-variceal upper gastrointestinal bleeding is a safe and effective,simple operation,no significant complications,hemostatic effect is remarkable,low-cost treatment,it is worth all hospitals to promote the application.