Sebastian S, McLoughlin R, Qasim A, O'Morain C A, Buckley M J
Department of Gastroenterology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Dig Liver Dis. 2004 Mar;36(3):212-7. doi: 10.1016/j.dld.2003.11.028.
Gastric antral vascular ectasia is a rare but well-recognised cause of occult gastrointestinal bleeding. Various endoscopic treatments have been tried in this condition. We report our experience with argon plasma coagulation in the treatment of gastric antral vascular ectasia.
Twelve patients with endoscopically proved gastric antral vascular ectasia were included. All patients received argon plasma coagulation with power of 40 W at a median interval of 4 weeks. The pre-treatment haemoglobin and transfusion requirements were compared with the post-treatment values.
There was a sustained increase in mean haemoglobin levels post-treatment. The mean haemoglobin levels pre- and post-treatment were 8.13 +/- 0.70 and 12.2 +/- 0.32 g/dl, respectively (P = 0.008). All patients were anaemic and 58.3% of the patients were transfusion dependent. The mean number of units of blood transfusion in the period 6 months prior to treatment was 11.3 +/- 5.68. Following argon plasma coagulation, the number of transfusions decreased significantly to 1.1 +/- 0.57 units (P = 0.018). No significant procedure-related complications were identified.
Argon plasma coagulation is a safe and effective alternative to the currently available endoscopic modalities of treatment for gastric antral vascular ectasia.
胃窦血管扩张是隐匿性胃肠道出血的一种罕见但已被充分认识的病因。针对这种情况已尝试了各种内镜治疗方法。我们报告了我们使用氩等离子体凝固术治疗胃窦血管扩张的经验。
纳入了12例经内镜证实为胃窦血管扩张的患者。所有患者均接受了功率为40W的氩等离子体凝固术,中位间隔时间为4周。将治疗前的血红蛋白水平和输血需求与治疗后的数值进行比较。
治疗后平均血红蛋白水平持续升高。治疗前和治疗后的平均血红蛋白水平分别为8.13±0.70和12.2±0.32g/dl(P = 0.008)。所有患者均贫血,58.3%的患者依赖输血。治疗前6个月期间的平均输血量为11.3±5.68单位。氩等离子体凝固术后,输血量显著减少至1.1±0.57单位(P = 0.018)。未发现与手术相关的重大并发症。
氩等离子体凝固术是目前可用的胃窦血管扩张内镜治疗方式的一种安全有效的替代方法。