Heater Probe Treatment of Angiodysplasia in Upper Gastrointestinal Bleeding

熱探針治療血管形成異常引起的上消化道出血

林瑞昌(Ruey-Chang Lin) ； 牟聯瑞(Lein-Ray Mo) ； 郭振源(Jenn-Yuan Kuo)

《中華民國消化系醫學會雜誌》 10卷2期 (1993/06) Pp. 142-148

https://doi.org/10.6557/GJTa.199306_10(2).0002

摘要

上消化道出血的原因，血管形成異常占有不可忽視的角色。在37個月期間，781例上消化道出血中有13例因血管形成異常導致出血。其中2例為尿毒症，其他無全身性疾病。女性8例，男性5例，年齡從7歲到72歲，平均49.8歲。紅色微凸的血管異常大小從l至4毫米。利用Olympus heater probe unit的熱探針輕壓，熱量從20或25焦耳起，視需要直到病灶變白，所需熱量為25~140焦耳。內視鏡追蹤壹星期時在治療處有潰瘍，壹個月時已痊癒。在平均14個月的追蹤過程中有一例在治療3個月後再出血，但經熱探針再止血迄今無再發。全部病人利用熱探針均能成功地止血。目前電子內視鏡具放大且高解像力可增加微小血管異常病灶的診斷率，同時利用熱探針止血應是方便、安全、有效的治療方式。

關鍵字

血管形成異常 ； 上消化道出血 ； 熱探針

並列摘要

Angiodysplasia has been recognized as the source of upper gastrointestinal bleeding. Over a 37-month period, we treated 13 patients with angiodysplastic bleeding using an Olympus video endoscope and a heater probe. The typical endoscopic appearance of angiodysplasia was seen as a reddish, discrete, flat or slightly elevated lesion with a diameter of 1-4mm. There were 8 females and 5 males ranging in age from 7 to 72 years old (mean age 49.8 years old). Two of them were uremic cases on maintenance hemodialysis. A total of 25 to 140 joules were applied to the lesions. After the heater probe was applied, an ulcelr was noted on the 7th day and healed at first month during endoscopic follow-up. Recurrent bleeding occurred in one case after 3 months and was retreated with heater probe. All patients were successfully treated by endoscopic heater probe without complication. None of them needed surgical intervention to control the bleeding. We therefore conclude that heater probe thermocoagulation is an effective, safe and convenient therapeutic method for the treatment of angiodysplastic bleeding in the upper gastrointestinal tract.

並列關鍵字

angiodysplasia ； upper gastrointestinal bleeding ； heater probe