结肠病变肠镜治疗后延迟性出血45例临床分析
发布时间：2018-08-27 12:37
【摘要】：目的分析结直肠病变肠镜治疗后延迟性出血的原因及再次肠镜治疗价值。方法回顾第三军医大学大坪医院2010年1月至2016年12月收治的结直肠隆起性病变(息肉、腺瘤、早癌、脂肪瘤)肠镜下给予氩气刀凝固术、黏膜下切除术、黏膜下剥离术或尼龙绳套扎术治疗后延迟出血的45例患者,针对其延迟性出血的病因,总结再次肠镜治疗的方式及临床结局。结果肠镜治疗后延迟性出血的好发部位依次是直肠(28.89%),乙状结肠(24.44%),升结肠(22.22%);腺瘤及上皮内瘤变病灶更易发生(88.89%)。延迟性出血的形式主要为病灶切除处创面渗血,也可有血管涌血或喷血。本组延迟性出血肠镜下治疗方式主要是钛夹夹闭和圈夹缝合,5例黏膜下注射1∶10 000肾上腺素及氩气刀凝固术治疗,35例氩气刀凝固术合并钛夹夹闭术治疗,3例钛夹夹闭治疗,2例圈夹止血治疗。42例一次性肠镜止血成功,3例又出血,再次行肠镜下治疗,1例重新给予钛夹夹闭及圈夹止血后出血停止,另2例转外科行结肠切除术。本组43例延迟性出血患者均经肠镜下止血成功,痊愈出院。肠镜治疗后牢固的创面处理对预防延迟性出血十分重要,患者的基础疾病及术后饮食管理也是延迟性出血的重要因素。结论对于肠镜治疗后延迟性出血患者及时再次进行肠镜检查及有效治疗,可取得满意的临床效果。
[Abstract]:Objective to analyze the causes of delayed bleeding after colonoscopy for colorectal lesions and the value of re-colonoscopy. Methods from January 2010 to December 2016, colorectal protuberance lesions (polyps, adenoma, early cancer, lipoma) were treated by argon coagulation and submucosal resection in Daping Hospital of the third military Medical University. Forty-five patients with delayed bleeding after submucosal dissection or nylon rope ligation were reviewed for the etiology of delayed hemorrhage and the clinical outcome of re-colonoscopy was summarized. Results the most common sites of delayed bleeding after endoscopy were rectum (28.89%), sigmoid colon (24.44%), ascending colon (22.22%), adenoma and intraepithelial neoplasia (88.89%). The main form of delayed hemorrhage is bleeding at the excision site of the lesion, and there may also be blood gushing or spurting blood. The main methods of endoscopic treatment for delayed hemorrhage were titanium clip clamping and ring suture combined with submucosal injection of 1:10 000 epinephrine and argon knife coagulation in 35 cases of argon knife coagulation combined with titanium clip closure in 3 cases of titanium. Two cases of clipping and hemostasis. 42 cases of one-time endoscopy hemostasis. 3 cases of bleeding. One case was retreated with titanium clip and the bleeding stopped after hemostasis by coil clamp. The other 2 cases were transferred to colectomy. All 43 cases of delayed hemorrhage were successfully hemostasis under enteroscopy and were cured and discharged. Solid wound management after endoscopy is very important to prevent delayed hemorrhage, and the basic diseases and postoperative diet management are also important factors for delayed hemorrhage. Conclusion for the patients with delayed hemorrhage after endoscopy, the clinical effect can be achieved by re-examination and effective treatment in time.
【作者单位】： 重庆市綦江区疾病预防控制中心;第三军医大学大坪医院野战外科研究所消化内科;
【分类号】：R574
本文编号：2207303
[Abstract]:Objective to analyze the causes of delayed bleeding after colonoscopy for colorectal lesions and the value of re-colonoscopy. Methods from January 2010 to December 2016, colorectal protuberance lesions (polyps, adenoma, early cancer, lipoma) were treated by argon coagulation and submucosal resection in Daping Hospital of the third military Medical University. Forty-five patients with delayed bleeding after submucosal dissection or nylon rope ligation were reviewed for the etiology of delayed hemorrhage and the clinical outcome of re-colonoscopy was summarized. Results the most common sites of delayed bleeding after endoscopy were rectum (28.89%), sigmoid colon (24.44%), ascending colon (22.22%), adenoma and intraepithelial neoplasia (88.89%). The main form of delayed hemorrhage is bleeding at the excision site of the lesion, and there may also be blood gushing or spurting blood. The main methods of endoscopic treatment for delayed hemorrhage were titanium clip clamping and ring suture combined with submucosal injection of 1:10 000 epinephrine and argon knife coagulation in 35 cases of argon knife coagulation combined with titanium clip closure in 3 cases of titanium. Two cases of clipping and hemostasis. 42 cases of one-time endoscopy hemostasis. 3 cases of bleeding. One case was retreated with titanium clip and the bleeding stopped after hemostasis by coil clamp. The other 2 cases were transferred to colectomy. All 43 cases of delayed hemorrhage were successfully hemostasis under enteroscopy and were cured and discharged. Solid wound management after endoscopy is very important to prevent delayed hemorrhage, and the basic diseases and postoperative diet management are also important factors for delayed hemorrhage. Conclusion for the patients with delayed hemorrhage after endoscopy, the clinical effect can be achieved by re-examination and effective treatment in time.
【作者单位】： 重庆市綦江区疾病预防控制中心;第三军医大学大坪医院野战外科研究所消化内科;
【分类号】：R574
【相似文献】
相关期刊论文 前1条
1 余英,余保平,汪福群;CD1小鼠胃肠道快速延迟性整流性钾通道基因的分布[J];世界华人消化杂志;2005年15期
，本文编号：2207303
本文链接：https://www.wllwen.com/yixuelunwen/xiaohjib/2207303.html
最近更新
教材专著
