内镜下治疗Dieulafoy病出血39例

目的观察内镜下治疗Dieulafoy病出血的疗效及安全性。方法 2004年6月～2009年6月我院对39例Dieulafoy病出血急诊行高张钠-肾上腺素液黏膜内注射联合射频及钛夹治疗。结果 36例经内镜止血成功,首次治疗成功34例(87.2%),2例经2次内镜止血成功(5.1%);3例外科手术治疗(7.7%)。内镜止血术后2～4周再行胃镜检查均未发现溃疡。39例随访0.5～5年,平均2年,均无再发出血。结论高张钠-肾上腺素液黏膜内注射联合射频及钛夹是治疗Dieulafoy病出血的一种较为安全有效的方法 。

Endoscopic Treatment of Dieulafoy's Disease: Report of 39 Cases

Objective To study the efficacy and safety of endoscopic management in upper gastrointestinal hemorrhage caused by Dieulafoy＇s disease. Methods From April 2006 to April 2009,totally 39 patients with Dieulafoy＇s diseases were admitted to our hospital because of gastrointestinal bleeding. Hypertonic saline-epinephrine injection and radiofrequency and hemoclipping were used as endoscopic therapeutic procedures for the patients. Results Of the 39 cases,the bleeding was successfully controlled in 36 cases by endoscopy; 34 of them （87.2%） were cured in one session,and the other two （5.1%） were controlled after a second operation. Three patients （7.7%） were cured by open surgery. No ulcer was observed by gastroscopy in 2 to 4 weeks after the endoscopic treatment.The 39 patients were followed up for 0.5 to 5 years with a mean of 2 years;none of them had hemorrhage during the period. Conclusions Hypertonic saline-epinephrine injection combined with radiofrequency and hemoclipping by endoscopic therapy is effective and safe for patients with Dieulafoy＇s disease.