Wördehoff D, Gros H
Endoscopy. 1982 Nov;14(6):196-9. doi: 10.1055/s-2007-1021620.
The diagnosis of an upper gastrointestinal bleeding can be clarified quickly and reliably by emergency endoscopy. It would seem reasonable to make this efficient diagnostic approach available for therapy in order to stop the bleeding. Over a period of 2 1/2 years, we discovered an active bleeding or several recurrences during emergency endoscopy in 36 patients with a high operative risk. In these cases we attempted local haemostasis by sclerosing injections. Most patients had signs of shock at the time of admission. The average haemoglobin level was 7:42 g/100 ml, the average blood requirement was 4,4 units in the first 24 hours. 12 patients had stress lesions, 19 patients important factors militating against an operation, namely age and serious primary diseases, 5 patients had other risk factors. In 33 out of 36 patients (91.9%) haemostasis was accomplished during endoscopy. In 7 patients recurrences occurred, 3 bleeds were arrested by a repeated sclerosing. Thus definitive haemostasis was achieved in 29 patients (80.6%). We believe that it is justified to attempt endoscopic sclerotherapy in high-risk patients before undertaking an emergency operation.
通过急诊内镜检查能够迅速且可靠地明确上消化道出血的诊断。为了止血，使这种高效的诊断方法应用于治疗似乎是合理的。在2年半的时间里，我们在36例手术风险高的患者的急诊内镜检查中发现了活动性出血或多次复发。在这些病例中，我们尝试通过硬化剂注射进行局部止血。大多数患者入院时都有休克体征。平均血红蛋白水平为7.42g/100ml，最初24小时的平均输血量为4.4单位。12例患者有应激性病变，19例患者有不利于手术的重要因素，即年龄和严重的原发性疾病，5例患者有其他危险因素。36例患者中有33例（91.9%）在内镜检查期间实现了止血。7例患者出现复发，3例出血通过再次硬化剂注射得以止住。因此，29例患者（80.6%）实现了确定性止血。我们认为，在进行急诊手术之前，对高危患者尝试内镜硬化治疗是合理的。
