Manegold B C
Abteilung für Endoskopie, Klinikum der Stadt Mannheim, Fakultät für klinische Medizin, Universität Heidelberg.
Schweiz Rundsch Med Prax. 1994 Jun 21;83(25-26):772-6.
Endoscopic hemostasis in cases of acute upper gastrointestinal bleeding may be achieved by various methods with comparable initial results, nevertheless the frequency of re-bleeding is different in regard to the techniques. The frequency of re-bleeding may be reduced by the application of fibrin tissue sealant, the eradication of Helicobacter pylori and by daily endoscopic controls. The use of big channel endoscopes makes intragastral survey easier, and beyond that endoscopic doppler-ultrasound may reveal visible and not visible arterial vessels on the bottom of the ulceration, so indicating the greater risk of re-bleeding. The progress of endoscopic hemostasis combined with specific pharmaco-therapy is on the way to relieve laparotomy in favour of intraluminal minimal invasive techniques in a larger scale.
急性上消化道出血病例的内镜止血可通过多种方法实现,初始结果相当,然而不同技术的再出血频率有所不同。应用纤维蛋白组织粘合剂、根除幽门螺杆菌以及每日进行内镜检查可降低再出血频率。大通道内镜的使用使胃内检查更容易,除此之外,内镜多普勒超声可发现溃疡底部可见和不可见的动脉血管,从而提示再出血风险更高。内镜止血与特定药物治疗相结合的进展正朝着在更大规模上用腔内微创技术取代剖腹手术的方向发展。