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[急性胃肠道出血的止血]

[Hemostasis in acute gastrointestinal bleeding].

作者信息

Timerbulatov V M, Timerbulatov Sh V, Sagitov R B

出版信息

Khirurgiia (Mosk). 2010(3):20-6.

Abstract

Retrospective analysis of treatment results was carried out in patients with acute bleedings from upper digestive tract according to efficacy evaluation of hemostatic methods. All methods of hemostasis were divided into 7 groups: resectional, local treatment of the bleeding source with or without vagotomy, angiosurgical, local surgical hemostasis, hemostasis along the length, endoscopic hemostasis and conservative modes. Indications for hemostatic methods were estimated depending on severity, intensity, character of the bleeding basing on the J. Forrest classification and severity of patient's condition (severity of blood loss). Prophylactic measures for prevention of recurrent bleedings after primary hemostasis are proposed. Differential approach to hemostasis in acute gastrointestinal bleedings allows achieving 96-97% efficacy.

摘要

根据止血方法的疗效评估,对急性上消化道出血患者的治疗结果进行回顾性分析。所有止血方法分为7组:切除法、有无迷走神经切断术的出血源局部治疗法、血管外科手术法、局部手术止血法、沿长度止血法、内镜止血法和保守模式。根据J. Forrest分类法以及出血的严重程度、强度、特征和患者病情(失血严重程度)来评估止血方法的适应症。提出了预防初次止血后复发性出血的预防措施。对急性胃肠道出血采用差异化止血方法可使疗效达到96-97%。

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