止血夹与注射疗法治疗Dieulafoy病出血的疗效比较(1)
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【摘要】 目的 观察内镜下放置止血夹与注射疗法在治疗Dieulafoy病出血中的疗效。 方法 回顾分析自2001年至2009年我院诊治的Dieulafoy病内镜下特点及治疗结局，比较内镜下止血夹与注射疗法的止血的疗效差异,分析治疗失败的原因。结果 ①21例 Dieulafoy病中男16例，女5例，平均年龄56.6岁，分别有11例行内镜下止血夹治疗，10例行注射治疗止血，两组间患者年龄、病变Forrest分级、平均输血量均有可比性；②采用止血夹治疗组止血成功率、再发出血率、 转手术治疗比例分别为72.7%、27.3%、18.2%，注射治疗组分别为60.0%、40.0%、20.0%,两组间止血疗效比较差异无统计学意义(P>0.05)；无内镜治疗相关的并发症发生；③内镜治疗后再次出血的时间均在48 h内。注射治疗组有2例再出血患者死亡。结论 内镜下放置止血夹及注射治疗均是治疗Dieulafoy病的有效方法再出血多见于内镜治疗后48 h内；死亡的患者存在高龄、合并慢性病等因素。
【关键词】
Dieulafoy病； 胃肠出血； 内镜
Comparison of endoscopic hemochipping and epinephrine injection for bleeding due to dieulafoys disease.
YANG Tao,LIN Manpeng,Liu Xiang,et al.Department of Gastroenterology，Second Hospital Affiliated to Guangzhou Medical College，Guangzhou510260, China
【Abstract】 Objective To evaluate the value of endoscopic hemochip placement and epinephrine injection for bleeding due to Dieulafoy lesions, and investigate the reason of failure treatment. Methods Endoscopic features of bleeding Dieulafoys disease and treatment outcome, who were admitted to the hospital between 2001and 2009, were analyzed retrospectively. Results A total of 21 patients includes 16 males and 5 females, whose average age was 56.6 years. Eleven patients were treat with haemostatic clipping, and ten cases were treat with epinephrine injection. The rate of initial hemosatasis, recurrent hemorrhage and transfer into surgery in hemochip group was similar to those in injeciton group (72.7%vs.60.0%, 27.3%vs.40.0%, and 18.2%vs.20.0% respedivly, P>0.05). No complication related to endoscopic treatment were founded in the two group patients. All recurrent bleeding were occurred in 48 h after endoscopic therapy. Two patients died in the injection group.Conclusion Endoscopic placement of hemochip and epinephrine injection are effective therapy for Dieulafoys with hemorrhea. Recurrent bleeding are often occurred in 48 h after endoscopic therapy. Aged and chronic disease are the risk factor of died.
【Key words】
Dieulafoy lesion；Hemorrhage；Endoscopy
作者单位：510260广州医学院第二附属医院消化内科 ......
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