Carter R, Anderson J R
University Department of Surgery, Royal Infirmary, Glasgow, UK.
Br J Surg. 1994 Jun;81(6):869-71. doi: 10.1002/bjs.1800810625.
Forty-nine consecutive patients with bleeding from peptic ulcers that would conventionally have required surgical intervention were randomized to receive endoscopic injection of adrenaline (1:10,000) or laser photocoagulation. Patients were included only if they had a visible vessel at endoscopic examination. Five patients proceeded directly to surgery and, of the remaining 44, 21 received laser photocoagulation and 23 injection therapy. Haemostasis was achieved initially in all patients. There was one rebleed in the group of patients who received laser treatment and four in those treated by injection. All five patients underwent further endoscopic haemostasis according to the initial randomization. Haemostasis was again achieved in all cases, but the patient who had undergone laser treatment suffered recurrent haemorrhage after a further 48 h and subsequently died. Overall, one of the 21 patients receiving laser treatment died compared with none of the 23 injected with adrenaline. Injection of adrenaline achieves similar results to laser photocoagulation for bleeding peptic ulcer.
四十九例传统上需要手术干预的消化性溃疡出血患者被随机分组，分别接受肾上腺素（1:10,000）内镜注射或激光光凝治疗。仅在内镜检查发现可见血管的患者才被纳入。五例患者直接进行了手术，其余44例中，21例接受激光光凝治疗，23例接受注射治疗。所有患者最初均实现了止血。接受激光治疗的患者组中有1例再次出血，接受注射治疗的患者中有4例再次出血。所有5例患者均根据最初的随机分组接受了进一步的内镜止血治疗。所有病例再次实现了止血，但接受激光治疗的患者在48小时后再次出血，随后死亡。总体而言，接受激光治疗的21例患者中有1例死亡，而注射肾上腺素的23例患者中无一例死亡。对于消化性溃疡出血，肾上腺素注射与激光光凝治疗效果相似。
