Department of Gastroenterology, Numune Education and Research Hospital, Ankara, Turkey.
Saudi J Gastroenterol. 2011 Mar-Apr;17(2):145-8. doi: 10.4103/1319-3767.77248.
Variceal bleeding is the most challenging emergent situation among the causes of upper gastrointestinal bleeding. Despite substantial improvement, a need remains for therapeutic armamentarium of such cases, which is easy, effective and without side-effect. Ankaferd blood stopper (ABS) is a standardized herbal extract acting as a hemostatic agent on the bleeding or injured areas. In this observational study, a total of four patients with variceal bleeding were treated with endoscopic ABS application. The lesions were bleeding gastric varices (n:3) and bleeding duodenal varix (n:1). ABS was selected as a bridge to definitive therapies due to unavailability or inappropriateness of bleeding lesions to conventional measures. ABS was instilled or flushed onto the bleeding areas by sclerotherotherapy needle or heater probe catheter. Periprocedural control of the bleeding was achieved in all instances. Thereafter, on an elective basis, two patients with gastric varices underwent cyanoacrylate injection, while third underwent Transjugular intrahepatic portosystemic shunt and embolization. The patient with duodenal varix refused further therapy, after a few hours after admission and was discharged. He again presented the same day with rebleeding, but died before any attempt could be made to control his bleeding. ABS seems to be effective in cases of variceal bleeding as a bridge to therapy. Its major advantages are the ease of use and lack of side-effects.
胃底食管静脉曲张破裂出血是上消化道出血最具挑战性的紧急情况之一。尽管有了实质性的改善，但对于这类病例的治疗手段仍有需求，需要一种简便、有效且无副作用的方法。安卡弗止血粉（ABS）是一种标准化的草药提取物，可作为止血剂作用于出血或受损部位。在这项观察性研究中，共有 4 名胃底食管静脉曲张破裂出血的患者接受了内镜下 ABS 治疗。病变为出血性胃静脉曲张（n=3）和出血性十二指肠静脉曲张（n=1）。由于出血病变不适合常规治疗或无法进行常规治疗，因此选择 ABS 作为桥接治疗方法。通过硬化治疗针或热探头导管将 ABS 注入或冲洗至出血部位。所有情况下均能达到术中止血控制。此后，两名胃静脉曲张患者择期接受了氰基丙烯酸酯注射治疗，第三名患者接受了经颈静脉肝内门体分流术和栓塞治疗。十二指肠静脉曲张患者在入院数小时后拒绝进一步治疗，随后出院。他当天再次出现再出血，并在试图控制出血之前死亡。ABS 作为治疗的桥梁，在胃底食管静脉曲张破裂出血的治疗中似乎是有效的。其主要优点是使用方便且无副作用。
