Dieulafoy病致上消化道大出血的诊断和治疗 (附8例临床报告)

目的 旨在探讨Dieulafoy病的诊断与治疗原则，以期为该病的诊治提供一定临床经验，方法 8例患者行急诊胃镜11次（3例各为2次，3例行选择性血管造影各1次，1例在剖腹探查术中行胃镜检查，结果 （1）4例在首次急诊胃镜后即明确诊断，1例在第2次急诊胃镜时发现出血病灶；2例经血管造影后发现出血部位：1例在剖腹探查术中再经胃镜检查而确诊。（2）3例在胃镜下局部喷洒止血药，硬化剂注射，电凝等联合治疗后止血成功；1例在血管造影中经动脉灌注药物后止血；3例经外科单纯血管缝扎术后止血，1例行胃大部切除术后止血，结论 Dieulafor病可经急诊胃镜和（或）血管造影获得早期诊断，出血部位采用药物，电凝等治疗仍不能止血者，应尽早手术治疗。

Diagnosis and Therapy of Upper Gastrointestinal Large Hemorrhage from 8 Patients with Dieulafoy Disease

Objective　To evaluate principle of diagnosis and therapy of Dieulafoy disease. Methods　8 cases were examined by emergency gastroscopy with 11 times including one case in the course of surgery operation. 3 cases of those were examined by angiography. Results　① 4 cases were diagnosed in the first emergency gastroscopy; 1 case was diagnosed in the second time; 2 cases were found in selective angiography; 1 case was diagnosed by emergency gastroscopy in the course of surgercy operation. ② 3 cases were stopped bleeding by local treatment which includes the combinations of spraying haemostatic,injecting hardener and high frequency electrocoagulation. 1 case was stopped bleeding by pouring haemostatic into the artery in the examination of angiography. 4 cases were stopped bleeding by surgery. Conclusion　Dieulafoy disease can early be achieved emergency gastroscopy and selective angiography.Failed local treatment of gastroscopy,surgery should be performed as early as possible.