摘要
目的评价经内镜皮圈套扎(EBL)治疗Dieulafoy病变出血的疗效及安全性。方法对31例Dieulafoy病出血患者随机采用EBL(n=16)或硬化剂注射(EIS,n=15)治疗,20例患者病灶位于胃,8例位于胃肠吻合口,3例位于十二指肠球部。EBL组采用多连发套扎器,通过负压抽吸,使Dieu lafoy病灶及周围组织吸入套扎帽内,然后释放弹力皮圈将其结扎。EIS组选用5%鱼肝油酸钠或1%乙氧硬化醇,绕Dieulafoy病灶周围注射止血。结果EBL组套扎组织在内镜治疗后3～7d内脱落;EBL组早期止血率、远期止血率和转外科手术率均与EIS组相似(分别为93.8%比86.7%,100.0%比86.7%,0比13.3%;P值均>0.05),但再出血率显著低于EIS组(6.3%比40.0%,P<0.05);EBL组并发症发生率为6.3%,EIS组为6.7%,差异无统计学意义(P>0.05)。结论EBL是内镜治疗Dieulafoy病变出血一种安全和有效的方法。
Objective To evaluate the efficacy and safety of endoscopic band ligation (EBL) in the treatment of hemorrhage due to Dieulafoy lesions. Methods Thirty-one patients with hemorrhagic ~Dieulafoy lesion were randomized to undergo either EBL or endoscopic injection sclerosis (EIS), 16 in EBL group and 15 in EIS group. Twenty patients with Dieulafoy's lesions were located at stomach, 8 at ~gastrointestinal stoma, 3 at duodenal bulb. The multishot ligation device was used in EBL group. Suction was applied, drawing the Dieulafoy lesion and the surrounding mucosa into the lumen of the ligator, ~preloaded elastic band was fired, and the Dieulafoy lesion was ligated by the elastic band. Endoscopic injection hemostasis with 5% sodium morrhuate or 1% aethoxysklerol was performed around Dieulafoy lesion in EIS group. Results The ligated tissue exfoliated from 3 days to 7 days after EBL; the rates of initial hemostasis, permanent hemostasis and transfer into surgery in EBL group was similar to those in EIS group (93.8% vs.86.7%, 100.0% vs. 86.7% and 0 vs.13.3% respective, P>0.05),but the rate of recurrent bleeding in EBL group was significantly lower than that in EIS group (6.3% vs. ~40.0% , P<0.05). There was no any statistically significant differences in the rate of complications of the two groups(6.3% in EBL group vs. 6.7% in EIS group, P>0.05). Conclusions EBL is an effective and safe ~endoscopic treatment for hemorrhagic Dieulafoy's lesion.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2005年第3期134-137,共4页
Chinese Journal of Digestion
关键词
经内镜皮圈套扎
治疗
DIEULAFOY病
出血
止血
Dieulafoy lesion
Hemorrhage
Endoscopic injection hemostasis
Endoscopic band ligation
