内镜黏膜下剥离术出血的处理

Dealing with the bleeding of endoscopic submucosal dissection

随着内镜黏膜下剥离术的开展与推广,预防其并发症的发生及发生并发症后的处理倍受关注,而内镜黏膜下剥离术的常见并发症包括出血和穿孔,其中最常见的并发症为出血,本文通过对国内外内镜粘膜下剥离术最近几年有代表性的文献的分析总结,来探讨对其最常见并发症出血的处理,本文将从术前评估病人(包括用药、常规的检查、查体)、术中防止出血并积极止血和仔细处理创面、术后迟发性出血和出现出血的预防及处理措施等方面叙述ESD相关性出血的处理。

With the development and popularization of endoscopic submucosal dissection（ ESD）,to prevent the occurrence of its complications and the treatment of the complications is concerned. The common complications of ESD include bleeding and perforation,and the most common complications is bleeding. By the way of analyzing and concluding typical literature about ESD published in recent years we review how to deal with the bleeding. This article will describe the treatment of ESD related hemorrhage from the preoperative evaluation of patients（ including medicine,regular examination,physical examination）,prevent bleeding and hemostasis and carefully deal with wounds during the operation,the prevention and treatment of delayed hemorrhage after operation.