组织黏合剂对内镜黏膜下剥离术难治性出血的临床疗效
Clinical efficacy of tissue adhesive on intractable bleeding during endoscopic submucosal dissection
目的 研究组织黏合剂对治疗内镜下黏膜剥离术(ESD)中难治性出血及预防迟发性出血的疗效.方法 上海复旦大学附属中山医院内镜中心自2006年9月至2013年8月在对9874例胃肠道黏膜或黏膜下肿瘤的患者行ESD治疗中,发生5例难治性出血(0.05%),在其他止血方法无效的情况下,运用注射和喷洒组织黏合剂的方法进行止血,观察其疗效及其并发症.结果 5例患者运用组织黏合剂后均止血成功,且未发生迟发性出血及穿孔.内镜随访2个月后,见创面愈合并瘢痕形成.结论 组织黏合剂对治疗ESD难治性出血快速、有效并安全.
更多Objective To investigate the efficacy of tissue adhesive on intractable bleeding during endoscopic submucosal dissection (ESD) and delayed bleeding.Methods A total of 9874 patients with gastrointestinal mucosal or submucosal tumors underwent ESD in our center from September 2006 to August 2013 and intractable bleeding occurred during ESD in 5 cases.Under the condition of no effective hemostasis methods,the tissue adhesive injection or spray were used to stop the bleeding.The efficacy and safety were evaluated.Results All the 5 cases were successfully managed by the hemostasis method with tissue adhesive without any adverse event.In follow-up of two months after operation,wound healing and scar formation were observed under endoscopy.Conclusion Tissue adhesive is safe,effective and fast for intractable bleeding during ESD and delayed bleeding.
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