摘要
目的 了解硬化剂加生物蛋白胶治疗ForrestⅠa ,Ⅱa级上消化道出血的疗效。方法 治疗组采用内镜直视下将针式导管自活检孔道送至病灶处 ,在血管周围分四点注射 5 %鱼肝油酸钠 ,然后将专用双腔导管通过胃镜活检孔把溶解好的医用生物蛋白胶喷洒在出血灶的面及其周围。对照组 :采用内镜下单纯注射5 %鱼肝油酸钠 ,方法同前 ,术后禁食 3～ 5d。两组在治疗期间 ,常规使用质子泵抑制剂 ,密切观察腹部体征及有无出血。结果 治疗组止血率达 10 0 .0 % ,近期再出血率 10 .7% ,2例行手术治疗 ,术后病检证实为胃底的平滑肌瘤和胃角的早期腺癌凸对照组止血率达 87.5 % ,近期再出血率 2 8.5 % ,出血 4例再行硬化剂治疗 ,仍有 2例再发出血转外科手术治疗 ,有 1例病检证实为胃癌。结论 硬化剂加生物蛋白胶治疗ForrestⅠa ,Ⅱa级上消化道出血的疗效肯定 ,止血率高 ,再出血率低 ,且无明显毒副作用 ,值得推广使用。
Objective:To investigate the clinical value of endoscopic therapy for upper digestive tract bleeding Forrest Ⅰa ,Ⅱa with endoscopic sclerotherapy plus biological protein gum.Methods: The patients in treatment group were treated with endoscopic sclerotherapy plus biological protein gum. The patients in control group only received endoscopic sclerotherapy.Results:The hemostasis rate of treatment group was 100% and the newly re-bleeding rate was 10.7%, only two cases were operated which were respectively confirmed as leiomyomas and adenocarcinoma through pathology . The hemostasis rate of control group was 87.5% and the newly re-bleeding rate was 28.5%.Four patients suffered bleeding were treated with sclerotherapy again.Two of them were cured ,other two were operated and one of them was confirmed adenocarcinoma. Conclusions:The method with endoscopic sclerotherapy plus biological protein gum for upper digestive tract bleeding Forrest Ⅰa 、 Ⅱa is a safe and effective method without toxic and side effect,which is worthy to be extensively used in clinic.
出处
《中国内镜杂志》
CSCD
2004年第3期56-58,共3页
China Journal of Endoscopy
关键词
硬化剂加生物蛋白胶
上消化道出血
治疗
sclerotherapy
biological protein gum
upper digestive tract bleeding
treatment
