上消化道急性应激性粘膜病变出血的内镜诊断和治疗

Upper gastrointestinal bleeding from mucosal lesion of acute stress

目的探讨上消化道急性应激性粘膜病变出血患者的内镜诊断和治疗。方法对上消化道急性应激性粘膜病变出血患者在 24小时内急查内镜，并进行镜下止血及其他治疗。结果 30例患者中一般性出血 20例，大出血 10例，其病变内镜下表现为 6种类型。单纯内镜下止血 7例全部有效，内镜下止血加静脉止血治疗 10例亦全部成功，内镜下止血加静脉止血加经胃管止血治疗 10例中 8例有效、死亡 2例，有 3例重症患者虽经内、外科综合治疗仍死亡 2例。结论急诊内镜不仅是上消化道急性应激性粘膜病变出血准确可靠的诊断手段，而且也是快速有效的治疗方法。

Objective Endoscopic diagnosis and treatment for upper gastrointestinal bleeding (UGIB) from mucosal lesion induced by acute stress is reported. Methods Emergent endoscopy was instituted within 24 hours when the patient was first consulted,meanwhile appropriate endoscopic and other measures for hemostasis were given. Results 6 different patterns of mucosal bleeding could be seen under the scope.Most bleedings were checked by perendoscopic means± intravenous hemostatics,while some massive bleeding from acute stress claimed more ways to stop it. Conclusion For most UGIB from acute stress due to mucosal lesion emergent endoscopy offers both correct diagnosis and effective therapy .