摘要
目的观察急诊内镜下金属夹治疗食管贲门黏膜撕裂症（Mallory-Weiss syndrome，MWS）所致的上消化道出血的止血效果和安全性。方法急诊内镜检查确诊MWS出血38例，活动性出血病灶（Forrest Ⅰ）14例和近期出血性病灶（Forrest Ⅱ）24例，在内镜下应用金属夹治疗24h、5d及1-2个月后复查内镜。结果金属夹治疗全部止血成功。手术时间12-40（24±3．6）min。金属夹治疗后无并发症，无再出血，也无死亡病例。内镜随访显示金属夹对组织无损伤，不影响MWS的愈合。1-2个月后复查内镜，30例金属夹已经脱落；8例未脱落，但病灶愈合，患者饮食正常。结论急诊内镜下金属夹治疗MWS引起的上消化道出血是一种非常有效、安全的急诊治疗措施。
Objective To observe the efficacy and safety of emergency endoscopic hemoclip placement for the treatment of upper gastrointestinal bleeding due to Mallory-Weiss syndrome （ MWS）. Methods Endoscopic hemoclip placement was conducted in 14 cases of active bleeding （Fon＇est Ⅰ ） and 24 cases of visible vessels or fresh adhesive clots （ Forrest Ⅱ ） , proven to have MWS by endoscopic examinations. Follow-up endoscopy was performed at 24 hours, 5 days, and 1 - 2 months after the procedure, respectively. Results Initial hemostasis was achieved in all patients treated with hemoclips. The operation time was 12-40 rain （mean,24 ± 3. 6 rain）. No complications, recurrent bleeding, or death happened. Follow-up endoscopy showed no evidence of hemoclip-induced tissue injuries or impairment to lesion healing related to hemoclipping. Re-examinations of endoscopy 1 - 2 months after the procedure showed the hemociip shedding in 30 cases and still grasping in. 8 cases （ which had healed lesions and normal diets）. Conclusions Emergency endoscopic hemoclip placement for the treatment of upper gastrointestinal bleeding due to MalloryWeiss syndrome is safe and effective.
出处
《中国微创外科杂志》
CSCD
2006年第2期95-96,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
金属夹
食道贵门黏膜撕裂症
上消化道出血
急诊内镜
Hemoclip
Mallory-Weiss syndrome
Upper gastrointestinal bleeding
Emergency endoscopy
