Albert J G, Peiffer K H
Z Gastroenterol. 2016 Mar;54(3):250-5. doi: 10.1055/s-0035-1566987. Epub 2016 Feb 19.
Gastrointestinal bleeding is a frequent emergency in daily clinical practice of a gastroenterologist. While incidence and mortality of gastrointestinal bleeding are decreasing in many countries, numbers of endoscopic procedures are increasing. Endoscopic therapy of non-variceal gastrointestinal bleeding is still mainly based on "classical" procedures like injection of vasoactive drugs (i. e. epinephrine) or blood derivates, application of through-the-scope hemoclips (TTSC), Argon plasma coagulation and bipolar coagulation. However, in the last years new endoscopic techniques especially for non-variceal gastrointestinal bleedings have become available and enriched our endoscopic equipment. For example, over-the-scope clips (OTSCs) surpass the size of TTSCs and have been successfully established for treatment of gastrointestinal bleeding and leak closure of fistulas and perforations. In addition, hemostatic powders were shown to achieve primary hemostasis in several cases of gastrointestinal bleeding. Besides a brief overview of "classical" endoscopic procedures for hemostasis of non-variceal gastrointestinal bleeding, this review focuses on new epidemiological data and uprising methods for endoscopic hemostasis.
在胃肠病学家的日常临床实践中,胃肠道出血是一种常见的急症。虽然在许多国家胃肠道出血的发病率和死亡率正在下降,但内镜检查的数量却在增加。非静脉曲张性胃肠道出血的内镜治疗仍然主要基于“经典”方法,如注射血管活性药物(如肾上腺素)或血液衍生物、使用经内镜止血夹(TTSC)、氩等离子体凝固和双极凝固。然而,在过去几年中,特别是用于非静脉曲张性胃肠道出血的新内镜技术已经出现,并丰富了我们的内镜设备。例如,全层内镜夹(OTSC)超过了TTSC的尺寸,并已成功用于治疗胃肠道出血以及瘘管和穿孔的漏口封闭。此外,止血粉在几例胃肠道出血病例中显示可实现初步止血。除了简要概述非静脉曲张性胃肠道出血止血的“经典”内镜方法外,本综述重点关注新的流行病学数据和新兴的内镜止血方法。