CAJ | 학술논문

目的探讨内镜下治疗结直肠出血的临床疗效.方法回顾性分析2008年6月至2011年6月复旦大学附属中山医院收治的104例结直肠出血患者的临床资料.内镜下治疗结直肠疾病术后出血,内镜下即可见出血部位;无内镜治疗史者,必须在内镜下迅速找到出血部位,了解其性质.内镜下首先应用1:1000冰去甲肾上腺素生理盐水充分冲洗肠腔,尽量吸引病灶周围血块,使镜下视野清晰,辨认出血部位;必要时可使用连续注水泵,以保证内镜下治疗视野的清晰.主要止血方法:(1)局部喷洒止血药物.(2)金属夹止血.(3)氩气离子凝固术.(4)硬化剂注射.(5)多技术联合止血.术后随访1～6个月.结果 104例结直肠出血患者中内镜治疗术后出血84例、外科手术后出血16例、结直肠原发疾病出血4例.初次成功止血97例,24 h内再出血7例(再次内镜下成功止血6例、止血失败转腹腔镜治疗1例),内镜下止血总有效率为99.04％(103/104).内镜治疗术后平均随访4.2个月,患者复查肠镜均无再出血发生.结论内镜下治疗结直肠出血是一种安全、有效的治疗方法.
목적 탐토내경하치료결직장출혈적림상료효.방법 회고성분석2008년6월지2011년6월복단대학부속중산의원수치적104례결직장출혈환자적림상자료.내경하치료결직장질병술후출혈,내경하즉가견출혈부위;무내경치료사자,필수재내경하신속조도출혈부위,료해기성질.내경하수선응용1:1000빙거갑신상선소생리염수충분충세장강,진량흡인병조주위혈괴,사경하시야청석,변인출혈부위;필요시가사용련속주수빙,이보증내경하치료시야적청석.주요지혈방법:(1)국부분쇄지혈약물.(2)금속협지혈.(3)아기리자응고술.(4)경화제주사.(5)다기술연합지혈.술후수방1～6개월.결과 104례결직장출혈환자중내경치료술후출혈84례、외과수술후출혈16례、결직장원발질병출혈4례.초차성공지혈97례,24 h내재출혈7례(재차내경하성공지혈6례、지혈실패전복강경치료1례),내경하지혈총유효솔위99.04％(103/104).내경치료술후평균수방4.2개월,환자복사장경균무재출혈발생.결론 내경하치료결직장출혈시일충안전、유효적치료방법.
Objective To investigate the clinical efficacy of endoscopic treatment for colorectal hemorrhage.Methods The clinical data of 104 patients with colorectal hemorrhage who were admitted to the Zhongshan Hospital of Fudan University from June 2008 to June 2011 were retrospectively analyzed.The conditions of the lesions of hemorrhage were identified directly under the endoscope.The enteric cavity was completely irrigated by 0.1％ norepinephrine saline to remove the blood clots around the lesions for providing a better vision.The main hemostatic methods included hemostatic drugs,metallic hemostatic clip,argon plasma coagulation,sclerosing agent injection,and various techniques combination.Patients were followed up for 1-6 months after the treatment.Results Eighty-four patients were diagnosed as with colorectal hemorrhage after endoscopy,16 patients were with colorectal hemorrhage after surgery,and 4 patients were with colorectal hemorrhage caused by primary colorectal diseases.Hemostasia was successfully completed in 97 patients.Seven patients had colorectal hemorrhage recurrence within 24 hours,and hemostasia was successfully completed in 6 patients,1 patient was converted to open surgery.The total successful rate of endoscopic hemostasis was 99.04％ (103/104).The mean time of follow-up was 4.2 months,and no colorectal hemorrhage recurrence was observed during the follow-up Conclusion Endoscopic hemostasis is safe and effective for the treatment of colorectal hemorrhage.