CAJ | 학술논문

目的：：探讨急诊内镜下止血治疗内镜下十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)术后迟发性出血的疗效。方法：回顾分析2013年1月—2014年12月接受急诊内镜下止血治疗的5例 EST 术后迟发性出血患者的临床资料,评价急诊内镜下止血治疗的疗效。结果：5例 EST 术后迟发性出血中3例发生于 EST 术后24 h 内,1例发生于术后3 d,1例发生于术后7 d。急诊内镜下发现出血灶后,采取电凝止血、肾上腺素溶液注射、硬化剂注射或金属夹夹闭的方法进行止血。所有患者均一次性止血成功,未发生再次出血。结论：急诊内镜下止血治疗 EST 术后迟发性出血操作简单、安全、有效。
목적：：탐토급진내경하지혈치료내경하십이지장유두괄약기절개술(endoscopic sphincterotomy,EST)술후지발성출혈적료효。방법：회고분석2013년1월—2014년12월접수급진내경하지혈치료적5례 EST 술후지발성출혈환자적림상자료,평개급진내경하지혈치료적료효。결과：5례 EST 술후지발성출혈중3례발생우 EST 술후24 h 내,1례발생우술후3 d,1례발생우술후7 d。급진내경하발현출혈조후,채취전응지혈、신상선소용액주사、경화제주사혹금속협협폐적방법진행지혈。소유환자균일차성지혈성공,미발생재차출혈。결론：급진내경하지혈치료 EST 술후지발성출혈조작간단、안전、유효。
Objective:To investigate the efficacy of emergency endoscopic hemostasis for the treatment of delayed bleeding after endoscopic sphincterotomy(EST).Methods:Clinical data of 5 patients with delayed bleeding after EST,who received emergen-cy endoscopic hemostasis during Jan 2013 and Dec 2014,were analyzed retrospectively,so as to evaluate the efficacy of emer-gency endoscopic hemostasis.Results:Delayed bleeding occurred within 24 h in 3 patients,3 d after EST in 1 patient,and 7 d after EST in 1 patient.Once the hemorrhagic lesion had been found by endoscopy,electrocoagulation,epinephrine injection, sclerosing agent injection,or hemoclipping was applied to hemostasis.Endoscopic hemostasis was successfully achieved in all pa-tients.No recurrent bleeding was observed during the follow-up.Conclusions:Emergency endoscopic hemostasis is simple to operate,safe and effective for the treatment of delayed bleeding after EST.