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胃底恒径动脉破裂出血的临床及内镜分析。

Clinical and endoscopic analysis of gastric Dieulafoy's lesion.

机构信息

Department of Gastroenterology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, Hubei Province, China.

出版信息

World J Gastroenterol. 2010 Feb 7;16(5):631-5. doi: 10.3748/wjg.v16.i5.631.

DOI:10.3748/wjg.v16.i5.631
PMID:20128034
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2816278/
Abstract

AIM

To investigate the incidence, location, clinical presentation, diagnosis and effectiveness of endoscopic treatment of gastric Dieulafoy's lesion (DL) in China.

METHODS

All patients who received emergency upper gastrointestinal (GI) endoscopy due to gastric DL from February 2000 to August 2008 at GI endoscopy center of Renmin Hospital of Wuhan University were included in this study. The clinical presentation, medical history, location and characteristics of DL methods and effectiveness of therapy of patients with DL were retrospectively analysed by chart reviews. Long-term follow-up data were collected at outpatient clinics or telephone interviews.

RESULTS

Fifteen patients were diagnosized with DL, which account for 1.04% of the source of bleeding in acute non-variceal upper GI bleeding. Common comorbidities were found in one patient with hypertension and diabetic mellitus. Hemoclip or combined therapy with hemoclip produced primary hemostasis in 92.8% (13/14) of patients.

CONCLUSION

DL is uncommon but life-threatening in China. Hemoclip proved to be safe and effective in controlling bleeding from DL.

摘要

目的

调查中国胃底恒径动脉(DL)病变内镜治疗的发生率、部位、临床表现、诊断和疗效。

方法

本研究纳入了 2000 年 2 月至 2008 年 8 月期间,在武汉大学人民医院内镜中心因胃 DL 接受紧急上消化道(GI)内镜检查的所有患者。通过病历回顾,分析了患者的临床表现、病史、DL 的位置和特征、以及 DL 患者的治疗方法和疗效。通过门诊或电话访谈收集了长期随访数据。

结果

15 例患者被诊断为 DL,占急性非静脉曲张性上 GI 出血的出血源的 1.04%。1 例患者同时患有高血压和糖尿病。在 92.8%(13/14)的患者中,使用止血夹或联合止血夹治疗可达到初步止血的效果。

结论

在中国,DL 虽然不常见,但具有生命威胁性。止血夹在控制 DL 出血方面被证明是安全有效的。

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本文引用的文献

1
[Clinical aspects and endoscopic management of gastrointestinal bleeding from Dieulafoy's lesion].[Dieulafoy病所致胃肠道出血的临床特点及内镜治疗]
Rev Esp Enferm Dig. 2007 Sep;99(9):505-10. doi: 10.4321/s1130-01082007000900005.
2
Endoscopic ultrasound (EUS)-guided angiotherapy of refractory gastrointestinal bleeding.内镜超声(EUS)引导下难治性胃肠道出血的血管治疗
Am J Gastroenterol. 2008 Feb;103(2):352-9. doi: 10.1111/j.1572-0241.2007.01616.x. Epub 2007 Nov 6.
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Clinical presentation and endoscopic management of Dieulafoy's lesions in an urban community hospital.城市社区医院中Dieulafoy病损的临床表现及内镜治疗
World J Gastroenterol. 2007 Aug 28;13(32):4333-5. doi: 10.3748/wjg.v13.i32.4333.
4
Hemostasis of Dieulafoy's lesions by argon plasma coagulation (with video).氩离子凝固术治疗Dieulafoy病的止血作用(附视频)
Gastrointest Endosc. 2007 Jul;66(1):20-6. doi: 10.1016/j.gie.2006.11.022.
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Endoscopic management and follow up of Dieulafoy lesion in the upper gastrointestinal tract.上消化道Dieulafoy病变的内镜治疗及随访
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Dieulafoy's lesion: management and long-term outcome.迪厄拉富瓦病:治疗与长期预后
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Dieulafoy's lesion.迪厄拉富瓦氏病损
Gastrointest Endosc. 2003 Aug;58(2):236-43. doi: 10.1067/mge.2003.328.
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Short-term and long-term benefits of endoscopic hemoclip application for Dieulafoy's lesion in the upper GI tract.内镜下金属钛夹治疗上消化道Dieulafoy病的近期和远期疗效
Gastrointest Endosc. 2003 May;57(6):653-6. doi: 10.1067/mge.2003.183.
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The usefulness of endoscopic hemoclipping for bleeding Dieulafoy lesions.内镜下止血夹治疗Dieulafoy病出血的有效性
Endoscopy. 2003 May;35(5):388-92. doi: 10.1055/s-2003-38780.
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Gastrointest Endosc. 2002 Apr;55(4):527-31. doi: 10.1067/mge.2002.122652.