Cello J P, Grendell J H
Ann Intern Med. 1986 Mar;104(3):352-4. doi: 10.7326/0003-4819-104-3-352.
Forty-three patients with recurrent bleeding from gastrointestinal vascular ectasias had endoscopic treatment with either an argon or a neodymium-YAG (yttrium-aluminum-garnet) laser. Although 22 patients had some rebleeding, only 6 patients required resection for recurrent hemorrhage not controlled by laser treatments. Overall, the number of blood transfusions per patient decreased significantly (p less than 0.0001) when calculated for 6-month periods before and after initial laser treatments (1.5 +/- 0.2 U/month compared to 0.5 +/- 0.1 U/month). Rebleeding after the initial laser treatment was significantly more likely in patients with upper gastrointestinal ectasias than in patients with colonic lesions only (p less than 0.005).
43例胃肠道血管扩张症复发性出血患者接受了氩激光或钕钇铝石榴石(Nd:YAG)激光内镜治疗。虽然22例患者出现了一些再出血,但只有6例患者因激光治疗无法控制的复发性出血而需要进行手术切除。总体而言,以初始激光治疗前后6个月为时间段计算,每位患者的输血量显著减少(p<0.0001)(初始激光治疗前为1.5±0.2单位/月,治疗后为0.5±0.1单位/月)。与仅患有结肠病变的患者相比,上消化道扩张症患者在初始激光治疗后更易发生再出血(p<0.005)。