急诊内镜在非静脉曲张性上消化道出血治疗中的应用价值

目的探讨急诊内镜在非静脉曲张性上消化道出血治疗中的应用价值。方法回顾性分析2008年1月至2013年12月在内蒙古自治区鄂尔多斯市中心医院和河北医科大学第四医院住院并接受急诊内镜治疗的非静脉曲张性上消化道出血患者210例的临床资料,记录内镜下诊断、病变部位、范围及出血征象等。内镜止血治疗方法包括药物喷洒止血、注射止血、氩离子凝固止血、钛夹止血及联合止血。结果210例患者中即时止血成功203例（96.7%）;48 h内再出血14例,再次急诊内镜下止血成功10例（71%）。共11例治疗无效,转外科手术治疗或介入血管栓塞,急诊内镜治疗总有效率为94.8%（199/210）。结论急诊内镜在非静脉曲张性上消化道出血治疗中起效迅速、疗效确切,是首选急救治疗方法。

Clinical Value of Esophageal Hemostasis in Acute Non-variceal Upper Gastrointestinal Bleeding

Objective To investigate the clinical value of esophageal hemostasis in acute non-variceal upper gastrointestinal bleeding.Methods This was a retrospective study of 210 Patients with acute non-variceal upper gastrointestinal bleeding and receiving endoscopic treatment who were admitted to the Central Hospital of Inner Mongolia Erdos and the Fourth Hospital of Hebei Medical University between January 1,2008 and December 31,2013.Endoscopic diagnosis,lesion location,lesion size and stigmata of recent hemorrhage were recorded.Endoscopic treatment comprised medicine aspersing,injection,thermocoagulation,clips and combination therapy.Results Of 210 patients,203 patients were hemostasia fater the first treatment,the first hemostatic rate was 96.7%（203/210）.14 patients bleeded again within 48 hours,10 were hemostasia after the secongd treatment.Atotal of 11 patients were given surgical intervention after failure endoscopic treatment.The total rate of hemostasia was 94.8%（199/210）.Conclusion Emergency endoscopic hemostatic therapy is the preferred treatment in acute non-variceal upper gastrointestinal bleeding.