Korolev M P, Fedotov L E, Ivanova N V, Orekhovskaia S V, Taronishvili A D
Vestn Khir Im I I Grek. 1999;158(3):16-20.
An experience of work of the department of general surgery with the course of endoscopy is presented. The endoscopic diagnosis and treatment of 2931 patients for 6 years were performed for bleedings from the upper parts of the gastrointestinal tract. Errors in endoscopic diagnosis made 5%. The authors divided them into three groups: methodical (preparing the patients, methods of examination), diagnostic (assessment of the substrate and type of bleeding, probability of recurrences), tactical (medical policy, dynamics of observations). Hemostasis in endoscopic arrest may be complete or temporary (stable or unstable). The most effective methods are thought to be coagulation, clipping and a combination of the methods. Medicamentous means are less effective. The authors recommend to be aware of the endoscopic possibilities and not to try to stop bleeding by any means thereby wasting time.
本文介绍了普通外科与内镜诊疗过程相关的工作经验。对2931例患者进行了为期6年的上消化道出血内镜诊断和治疗。内镜诊断错误率为5%。作者将其分为三组:方法性(患者准备、检查方法)、诊断性(出血部位和类型的评估、复发概率)、策略性(医疗策略、观察动态)。内镜止血可能是完全的或暂时的(稳定或不稳定)。最有效的方法被认为是凝血、夹闭以及两种方法联合使用。药物手段效果较差。作者建议了解内镜诊疗的可能性,不要试图不惜一切代价止血从而浪费时间。