Peng Y C, Tung C F, Chow W K, Chang C S, Chen G H, Hu W H, Yang D Y
Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan.
J Clin Gastroenterol. 2001 Feb;32(2):119-22. doi: 10.1097/00004836-200102000-00005.
Therapeutic endoscopy with isotonic saline-epinephrine (ISE) injection is a convenient and widely used procedure for hemostasis in upper gastrointestinal bleeding. We retrospectively evaluated 36 patients (from January 1996 to April 1999) who had been diagnosed with recent or active bleeding due to Mallory-Weiss tears in emergency endoscopic examination. The endoscopic hemostatic method with ISE injection was performed in 15 of 36 patients. The other 21 patients received conservative treatment with hemodynamic support. Patient's clinical data, laboratory data, transfusion requirements, endoscopic findings, and length of hospital stays were evaluated. Initial hemoglobin was significantly lower in the ISE group than the conservative treatment group (9.74 +/- 2.86 g/dL vs. 12.57 +/- 2.80 g/dL, respectively; p < 0.01). Mean transfusion requirements were significantly higher in the ISE group than the conservative treatment group (7.26 +/- 8.78 units vs. 2.85 +/- 6.21 units, respectively; p < 0.1). Patients in the ISE group were supposed to be having a more severe bleeding episode. Most patients achieved initial hemostasis in the ISE group and the conservative treatment group (93% and 95%, respectively). The rebleeding rate was also similar in both groups (1 in 15 in the ISE group and I in 21 in the conservative treatment group). There was no significant difference in length of hospital stay and rebleeding between these two groups (3.47 +/- 1.92 days vs. 2.47 +/- 1.47 days, respectively: p = 0.89). The endoscopic ISE injection is an inexpensive, simple, convenient therapeutic method and it can achieve initial hemostasis for active Mallory-Weiss tears.
用等渗盐水-肾上腺素（ISE）注射进行治疗性内镜检查是上消化道出血止血的一种方便且广泛应用的方法。我们回顾性评估了36例患者（1996年1月至1999年4月），这些患者在急诊内镜检查中被诊断为因马洛里-魏斯撕裂伤导致近期或活动性出血。36例患者中有15例接受了ISE注射的内镜止血方法。另外21例患者接受了血流动力学支持的保守治疗。评估了患者的临床资料、实验室数据、输血需求、内镜检查结果和住院时间。ISE组的初始血红蛋白水平显著低于保守治疗组（分别为9.74±2.86 g/dL和12.57±2.80 g/dL；p<0.01）。ISE组的平均输血需求量显著高于保守治疗组（分别为7.26±8.78单位和2.85±6.21单位；p<0.1）。ISE组的患者被认为出血情况更严重。ISE组和保守治疗组的大多数患者都实现了初始止血（分别为93%和95%）。两组的再出血率也相似（ISE组15例中有1例，保守治疗组21例中有1例）。两组之间的住院时间和再出血情况无显著差异（分别为3.47±1.92天和2.47±1.47天；p = 0.89）。内镜ISE注射是一种廉价、简单、方便的治疗方法，它可以实现活动性马洛里-魏斯撕裂伤的初始止血。
