胃Dieulafoy病的内镜诊断和治疗

目的：探讨胃Dieulafoy病的内镜诊断和治疗方法。方法：回顾性分析作者自1994年1月～2002年6月经内镜诊断和治疗胃Dieulafoy病的临床资料。结果：12例均在入院后2h之内行急诊内镜检查，经一次检查确诊10例．二次检查确诊2例。经内镜局部喷洒0．1％去甲肾上腺素治疗博动性出血3例，仅1例暂时止血约12h后再出血。电凝治疗11例均止血成功。结论：急诊内镜是诊断胃Dieulafoy病的最佳手段，浅表溃烂伴博动性或喷射状出血是内镜诊断的主要依据，单独的暗红色血痂或黑褐小隆起是内镜诊断的重要线索。经内镜局部喷洒止血药疗效不佳，电凝是治疗该病的有效手段。

ENDOSCOPIC DIAGNOSIS AND TREATMENT OF DIEULAFOY'S DISEASE

Objective:To investigate the endoscopic diagno sis and treatment of Dieulafoy' s disease.Methods:The clinical data of Dieulafoy's disease patients from January 1994 to June 2002 were analyzed retrospectively.Results:Of 12 cases, all experienced endoscopic examination 2 h ours in hospital, 10 cases were diagnosed once, 2 cases were diagnosed after examination more. Endoscopic local spraying of 0.1% noradrenalin was p erformed in 3 cases with pulsing bleeding, which only 1 case stopped bleeding te mporarily and bleed again 12 hours later. Hemorrhage stopped successfully after high frequency electrocoagulation in 11 cases.Conclusions:Emegency endoscopic examination is the best way to d iagnose Dieulafoy's disease. Surface ulcer with pulsing or spouting bleeding is the main diagnosis evidence, single wine blood scab or black-brown small bump is important endoscopic diagnosis clue. Electrocoagulation is effectiv e therapy while endoscopic local spraying of hemostat doesn't work well.