Yamasaki Yasushi, Takenaka Ryuta, Nunoue Tomokazu, Kono Yoshiyasu, Takemoto Koji, Taira Akihiko, Tsugeno Hirofumi, Fujiki Shigeatsu
Hepatogastroenterology. 2014 Nov-Dec;61(136):2272-6.
BACKGROUND/AIMS: Upper gastrointestinal hemorrhage from bleeding peptic ulcer is sometimes difficult to treat by conventional endoscopic methods. Recently, monopolar electrocoagulation using a soft-coagulation system and hemostatic forceps (soft coagulation) has been used to prevent bleeding during endoscopic submucosal dissection. The aim of this study was to assess the safety and efficacy of soft coagulation in the treatment of bleeding peptic ulcer.
A total of 39 patients with peptic ulcers were treated using soft coagulation at our hospital between January 2005 and March 2010. Emergency treatment employed an ERBE soft-mode coagulation system using hemostatic forceps. Second-look endoscopy was performed to evaluate the efficacy of prior therapy. Initial hemostasis was defined as accomplished by soft coagulation, with or without other endoscopic therapy prior to soft coagulation. The rate of initial hemostasis, rebleeding, and ultimate hemostasis were retrospectively analyzed.
The study subjects were 31 men and 8 women with a mean age of 68.3±13.7 years, with 29 gastric ulcers and 10 duodenal ulcers. Initial hemostasis was achieved in 37 patients (95%). During follow-up, bleeding recurred in two patients, who were retreated with soft coagulation.
The monopolar soft coagulation is feasible and safe for treating bleeding peptic ulcers.
背景/目的：消化性溃疡出血导致的上消化道出血有时难以通过传统内镜方法治疗。最近，使用软凝系统和止血钳的单极电凝术（软凝）已被用于在内镜黏膜下剥离术中预防出血。本研究的目的是评估软凝治疗消化性溃疡出血的安全性和有效性。
2005年1月至2010年3月期间，我院共对39例消化性溃疡患者采用软凝治疗。急诊治疗采用ERBE软模式凝系统和止血钳。进行二次内镜检查以评估先前治疗的疗效。初始止血定义为通过软凝实现，无论软凝之前是否进行其他内镜治疗。对初始止血率、再出血率和最终止血率进行回顾性分析。
研究对象为31名男性和8名女性，平均年龄68.3±13.7岁，其中胃溃疡29例，十二指肠溃疡10例。37例患者（95%）实现了初始止血。随访期间，2例患者再次出血，再次接受软凝治疗。
单极软凝治疗消化性溃疡出血可行且安全。
