經內視鏡對上胃腸道出血疾患之療效

Endoscopic Hemostasis for Upper Gastrointestinal Hemorrhage

吳國良(Kuo-Liang Wu) ； 程東照(Tung-Chao Cheng)

《Journal of Medical Sciences》 8卷5期 (1988/03) Pp. 325-331

摘要

Patients with upper gastrointestinal hemorrhage were studied for endoscopic hemostasis from December 1982 to November 1987. Ninety-five patients with upper G-I non-variceal bleeding received the treatment of endoscopic electrocoagulation. There were 76 patients with upper G-I bleeding for Nd:YAG laser therapy and 30 receiving pure alcohol treatment. The successful hemostatic rates were 92.6%, 89.5%, and 93.3% in each group treated by electrocoagulation, laser and pure alcohol. There was no significant statistical difference among those methods. (P ＞ 0.05) The rebleeding rate in the group treated by electrocoagulation, laser and pure alcohol showed 7.4%, 10.5% and 6.7% respectively. (P ＞ 0.05) The mortality rate due to uncontrolled G-I bleeding among the treated group had 1.1%, 1.3% and 0% respectively. The successful hemostatic, rebleeding, operative and moratality rates in the group treated by endoscopic sclerosis of esophageal variceal bleeding in 25 patients revealed 80%, 20%, 12%, 32%, and 16% respectively. Though the course of disease itself could not be healed by endoscopic hemostasis completely, the morbidity and mortality of G-I bleeding can be stabilized by emergency endoscopic examination and treatment, especially in the patient who is at high risk for any other emergency surgical procedure.

關鍵字

內視鏡 ； 上胃腸道出血 ； 電燒法 ； 雷射法

並列摘要

Patients with upper gastrointestinal hemorrhage were studied for endoscopic hemostasis from December 1982 to November 1987. Ninety-five patients with upper G-I non-variceal bleeding received the treatment of endoscopic electrocoagulation. There were 76 patients with upper G-I bleeding for Nd:YAG laser therapy and 30 receiving pure alcohol treatment. The successful hemostatic rates were 92.6%, 89.5%, and 93.3% in each group treated by electrocoagulation, laser and pure alcohol. There was no significant statistical difference among those methods. (P ＞ 0.05) The rebleeding rate in the group treated by electrocoagulation, laser and pure alcohol showed 7.4%, 10.5% and 6.7% respectively. (P ＞ 0.05) The mortality rate due to uncontrolled G-I bleeding among the treated group had 1.1%, 1.3% and 0% respectively. The successful hemostatic, rebleeding, operative and moratality rates in the group treated by endoscopic sclerosis of esophageal variceal bleeding in 25 patients revealed 80%, 20%, 12%, 32%, and 16% respectively. Though the course of disease itself could not be healed by endoscopic hemostasis completely, the morbidity and mortality of G-I bleeding can be stabilized by emergency endoscopic examination and treatment, especially in the patient who is at high risk for any other emergency surgical procedure.

並列關鍵字

Endoscopichemostaisis ； Electrocoagulation