Meier A, Messmann H, Gölder S K
III. Medizinische Klinik, Klinikum Augsburg, Stenglinstr. 2, 81656, Augsburg, Deutschland.
Med Klin Intensivmed Notfmed. 2015 Oct;110(7):515-20. doi: 10.1007/s00063-015-0077-0. Epub 2015 Sep 7.
Endoscopic hemostasis is the daily challenge that must be mastered by gastroenterologists. An emergency colonoscopy is the procedure of choice for lower gastrointestinal bleeding because of the diagnostic and therapeutic potential. Colonoscopy should be performed after oral preparation with 4-6 l polyethylene glycol solution within 12 h. In the case of massive hematochezia, colonoscopy without oral preparation employinga mechanical pump is possible and is not associated with a higher rate of complications. Many different endoscopic techniques are available (injection therapy, hemoclips, thermal coagulation, topical hemostatic substances). The suitable and most effective method must be chosen depending on the source of bleeding.
内镜止血是胃肠病学家必须掌握的日常挑战。急诊结肠镜检查因其诊断和治疗潜力,是下消化道出血的首选检查方法。结肠镜检查应在口服4-6升聚乙二醇溶液进行肠道准备后12小时内进行。对于大量便血的情况,不进行口服肠道准备而使用机械泵进行结肠镜检查是可行的,且并发症发生率不会更高。有许多不同的内镜技术可供选择(注射疗法、止血夹、热凝术、局部止血药物)。必须根据出血源选择合适且最有效的方法。