Sim E, Tekant Y, Kum C K, Goh P
Department of Surgery, National University Hospital, Lower Kent Ridge, Singapore.
J R Coll Surg Edinb. 1991 Dec;36(6):388-91.
Endoscopic haemostasis is becoming increasingly important in the management of bleeding peptic ulcers. In this study, rather than being confined to one modality of treatment, the endoscopist was allowed to customize the treatment according to the configuration of the ulcer, accessibility, and rate of bleeding in any particular patient. Fifty patients with actively bleeding peptic ulcers or stigmata of recent haemorrhage were treated endoscopically. Initial haemostasis was achieved in 48 (96%) patients. Eleven patients rebled of whom eight underwent repeat endoscopic treatment. Of these eight patients, three rebled of whom two required surgery. Permanent haemostasis was achieved in 43 of 50 patients (86%). The rate of surgery in the endoscopically treated group was 10%. There was one death due to causes not related to bleeding. The multimodality approach is a useful method of treatment in bleeding peptic ulcers, giving flexibility to the endoscopist in deciding on the best way to deal with the problem.
内镜下止血在消化性溃疡出血的治疗中变得越来越重要。在本研究中，内镜医师并非局限于一种治疗方式，而是被允许根据溃疡的形态、可达性以及任何特定患者的出血速度来定制治疗方案。50例有活动性消化性溃疡出血或近期出血迹象的患者接受了内镜治疗。48例（96%）患者实现了初始止血。11例患者再次出血，其中8例接受了重复内镜治疗。在这8例患者中，3例再次出血，其中2例需要手术治疗。50例患者中有43例（86%）实现了永久性止血。内镜治疗组的手术率为10%。有1例死亡，死因与出血无关。多模式方法是治疗消化性溃疡出血的一种有用方法，使内镜医师在决定处理问题的最佳方式时有更大的灵活性。
