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目的:探讨黏膜下药物注射联合氩离子凝固治疗慢性放射性肠病出血的有效性和安全性。方法:对42例均经过药物灌肠或口服,其中3例加用高压氧治疗仍有顽固性出血者,应用结肠镜黏膜下注射联合氩离子凝固并随访,观察治疗前后便血情况、血红蛋白水平、病变面积和黏膜脆性,以及治疗后的并发症。结果:治疗后便血次数和量明显减少(P<0.005和P<0.000 1),血红蛋白水平明显上升(P<0.01),病变面积缩小和黏膜脆性减少(P<0.000 2或0.000 01)。除2例合并溃疡出血,40例经过1次或2次治疗,1次有效率87.5%(35/40),总有效率达100%(40/40)。40例随访期间(平均68.5个月)维持缓解。无严重的并发症。结论:内镜黏膜下药物注射联合氩离子凝固治疗慢性放射性肠病出血安全有效。
Objective: To investigate the efficacy and safety of submucosal drug injection combined with argon ion coagulation in the treatment of hemorrhage of chronic radiation enteropathy. Methods: Forty-two patients were treated with drug enema or orally. Among them, 3 patients were treated with hyperbaric oxygen for refractory hemorrhage. Colonoscopic submucosal injection combined with argon ion coagulation and follow-up were performed. Blood stool, hemoglobin, Area and mucosal fragility, and post-treatment complications. Results: The number and amount of blood in the stool decreased significantly after treatment (P <0.005 and P <0.0001), hemoglobin level increased significantly (P <0.01), lesion area decreased and mucosal fragility decreased (P <0.0002 or 0.000 01). In addition to 2 cases with ulcer bleeding, 40 cases after 1 or 2 times treatment, the first effective rate 87.5% (35/40), the total effective rate was 100% (40/40). During the follow-up period of 40 cases (average 68.5 months), remission was maintained. No serious complications. Conclusion: Endoscopic submucosal drug injection combined with argon ion coagulation in the treatment of chronic radiation-induced intestinal bleeding is safe and effective.