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目的观察内镜下金属止血夹治疗急性非静脉曲张消化道出血的治疗效果。方法收集我院2004年7月至2009年7月收治的急性非静脉曲张消化道出血患者79例,在内镜下明确出血部位,使用止血夹钳夹止血。结果 79例急性非静脉曲张消化道出血患者应用内镜下金属止血夹止血治疗,共用金属夹238枚,平均每例3.01枚,即时止血率97.47%(77/79),20例止血夹止血失败病例中1例Dieulafoy病患者改用内镜下套扎治疗止血成功,另1例转外科手术治疗。1周内再出血率3.80%(3/79),其中2例患者转手术治疗。所有患者内镜术后均未出现内镜治疗相关并发症,全组无死亡病例。结论内镜下金属止血夹是一种治疗急性非静脉曲张消化道出血的有效方法,具有操作简单,止血效率高及无明显并发症等优点,值得临床推广应用。
Objective To observe the therapeutic effect of endoscopic metallic hemostatic clip in the treatment of acute non-variceal hemorrhage. Methods A total of 79 patients with acute non-variceal hemorrhage in our hospital from July 2004 to July 2009 were collected. The hemorrhage site was clearly identified by endoscopy and hemostatic clamp was used to stop the bleeding. Results 79 patients with acute non-variceal hemorrhage were treated with endoscopic metal hemostatic clip. There were 238 metal clips in total, with an average of 3.01 cases per patient. The immediate hemostasis rate was 97.47% (77/79), and 20 hemostatic clips failed to stop bleeding A case of Dieulafoy disease patients switched to endoscopic ligation treatment of hemostasis success, another case of surgical treatment. The rate of rebleeding was 3.80% (3/79) within 1 week, of which 2 patients underwent surgery. No endoscopic complications were found in all patients after endoscopic surgery. No deaths were found in the whole group. Conclusion Endoscopic metal hemostatic clip is an effective method for the treatment of acute non-variceal hemorrhage. It has the advantages of simple operation, high hemostatic efficiency and no obvious complications, which is worthy of clinical application.