经内镜皮圈套扎治疗Dieulafoy病变出血的近远期疗效分析

目的评价经内镜皮圈套扎治疗Dieulafoy病变出血的疗效及安全性。方法对28例Dieulafoy病变出血患者采用内镜下皮圈套扎治疗,其中17例病灶位于胃,8例位于胃肠吻合口,3例位于十二指肠球部。选用多连发套扎设备,通过负压抽吸,使Dieulafoy病变及其周围组织吸入套扎帽内,然后释放弹力皮圈将其结扎。结果套扎组织在内镜治疗后3～7d内脱落;早期止血率92.9%,活动性出血止血率100%,再出血率7.1%,转外科手术率0%,并发症发生率3.6%。随访4～68个月,平均33个月,长期止血率99.5%。结论经内镜皮圈套扎是治疗Dieulafoy病变出血的一种安全和有效的方法。

Long-term follow-up of endoscopic band ligation in the treatment of Dieulafoy's lesion hemorrhage

Objective] To evaluate the efficacy and safety of endoscopic band ligation in the treatment of Dieulafoy's lesion hemorrhage. Methods] Twenty -eight patients with Dieulafoy's lesion hemorrhage were selected to undergo endoscopic band ligation. Dieulafoy's lesions in 17 patients were located at stomach, 8 at gastrointestinal stoma, 3 at duodenal bulb. The multishot ligation device was used in EBL group. Suction was applied, drawing the Dieulafoy's lesion and the surrounding mucosa into the lumen of the ligator, and preloaded elastic band was fired and the Dieulafoy's lesion was ligated by the elastic band. Result] The ligated tissue exfoliated from three days to seven days after EBL; The rates of initial hemostasis was 92.9%, the rate of controlling active bleeding 100%, the rate of recurrent bleeding 7.1%, the rate of transfer into surgery 0%, and the rate of complications 3.6%. The following up ranged from 4 to 64 months, averaging 30 months, and the rate of permanent hemostasis was 99.5%. Conclusion] Endoscopic band ligation is an effective and safe endoscopic treatment for Dieulafoy's, lesion hemorrhage.