Kalloo A N, Canto M I, Wadwa K S, Smith C L, Gislason G T, Okolo P I, Pasricha P J
Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Gastrointest Endosc. 1999 Apr;49(4 Pt 1):518-21. doi: 10.1016/s0016-5107(99)70055-6.
A major problem in the endoscopic management of acute upper gastrointestinal (GI) bleeding is the presence of blood and clots overlying the bleeding source, preventing visualization of the lesion. A simple alternative is to alter the characteristics of blood such that it not only becomes easier to remove but also becomes translucent. We report the results of a pilot study on the use of hydrogen peroxide in patients with acute upper GI bleeding.
Patients with acute upper GI bleeding were studied if the presence of blood or clots obscured the site of bleeding. The potential site of bleeding was initially sprayed with 200 mL water and then with 200 mL 3% hydrogen peroxide mixed with simethicone.
In 6 patients with acute upper GI bleeding, hydrogen peroxide spray resulted in good to excellent visualization of the bleeding source. Hemostasis occurred in 2 patients who were actively bleeding. There were no adverse effects or complications.
Hydrogen peroxide significantly enhanced clot dissolution and endoscopic visualization in patients with acute upper GI bleeding.
急性上消化道出血内镜治疗的一个主要问题是出血源上覆盖有血液和血凝块，妨碍了病变的观察。一种简单的替代方法是改变血液的特性，使其不仅更容易清除，而且变得半透明。我们报告了一项关于过氧化氢用于急性上消化道出血患者的初步研究结果。
如果血液或血凝块掩盖了出血部位，则对急性上消化道出血患者进行研究。首先向潜在出血部位喷洒200毫升水，然后喷洒200毫升与西甲硅油混合的3%过氧化氢。
在6例急性上消化道出血患者中，过氧化氢喷雾使出血源的观察效果良好至极佳。2例活动性出血患者实现了止血。未出现不良反应或并发症。
过氧化氢显著增强了急性上消化道出血患者的血凝块溶解和内镜观察效果。
