食管、贲门癌术后上消化道出血的诊治

Endoscopic application on the treatment of upper gastrointestinal hemorrhage after esophageal and cardiac carcinoma resection

[目的]报道食管、贲门癌术后上消化道出血的诊治疗效。[方法]对34例食管、贲门癌术后上消化道出血患者进行药物保守治疗或内镜下手术治疗。[结果]34例中19例保守治疗康复;6例内镜下止血成功;9例经保守治疗无效,内镜引导下开胸探查止血8例康复,死亡1例。[结论]上消化道出血是食管、贲门癌术后严重的并发症,早期诊断是治疗的关键,内镜辅助及时开胸止血是重要的抢救措施。

[Objective]To summarize the causes and endoscopic treatment experience of upper gastroin- testinal hemorrhage after the surgery of gastroesophageal anastomosis. [Methods]The total of 2 568 pa tients with cardiac cancer and esophageal carcinoma who underwent gastroesophagostomy between January 2003 and January 2013 were involved and postoperative upper gastrointestinal hemorrhage was observed in 34 patients. [Results]Nineteen patients were recovered by conservative treatment, 6 patients by endoscopic therapy. And 9 patients were underwent endoscopic-assisted reoperation to stop hemorrhage, and 1 was dead. [Conclusion]Postoperative upper gastrointestinal hemorrhage is an potentially life-threatening com- plication. It is the most significant to do good performance during surgery and early diagnosis for treatment of upper gastrointestinal hemorrhage. Endoscopic therapy is the important measures for the postoperative complications.