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近年来,内镜下直接喷洒止血药物治疗上消化道出血方法较多,疗效各异。我院于1990年6月至1991年2月,用5%鱼肝油酸钠镜下喷洒治疗急性上消化道出血,止血效果满意,现报告如下。资料与方法(一)病例选择:病例均经紧急内镜检查确诊有上消化道活动性出血,其中12指肠球部溃疡4例,肝硬化食道、胃底静脉曲张2例,胃溃疡1例,复合溃疡1例,急性出血性胃炎1例,食道贲门癌1例。7例出血量在500~1500毫升之间,3例大于1500毫升,其中2例为胃底静脉曲张出血,1例是急性出血性胃炎。(二)治疗方法:常规胃镜检查,镜下寻找出血部位,找见活动性出血灶,对准出血点直接喷洒5%鱼肝油酸钠20~30ml,观察5~10分钟,待出血停止后退镜。术后禁食,输血补液及纠正休克等治疗。(三)疗效标准:有效:术后12~24小时内止血,表现不再呕血、排黑便,如排黑便应识别残留肠道积血(便次减少,黑便由稀变干),脉搏、血压正常,血色
In recent years, endoscopic direct spraying of hemostatic drugs to treat upper gastrointestinal bleeding more, with different effects. Our hospital in June 1990 to February 1991, with 5% sodium cod liver oil spray treatment of acute upper gastrointestinal bleeding, hemostatic effect is satisfactory, are as follows. Materials and methods (a) case selection: patients were confirmed by emergency endoscopy confirmed upper gastrointestinal bleeding, 12 cases of 4 cases of ulcer in the duodenum, cirrhosis of the esophagus, gastric varices in 2 cases, 1 case of gastric ulcer , 1 case of complex ulcer, 1 case of acute hemorrhagic gastritis and 1 case of esophageal and cardiac cancer. 7 cases of bleeding between 500 to 1500 ml, 3 cases greater than 1500 ml, of which 2 cases of gastric variceal bleeding, 1 case of acute hemorrhagic gastritis. (B) treatment: conventional gastroscopy, microscopic examination of bleeding sites, to find the active hemorrhage, aimed at bleeding directly spray 5% sodium codlate 20 ~ 30ml, observed 5 to 10 minutes until the bleeding stop after the mirror. Postoperative fasting, blood transfusion and correction of shock and other treatment. (C) efficacy criteria: effective: 12 to 24 hours after surgery to stop bleeding, the performance no longer hematemesis, Pai Pai black, such as Pai black should identify residual intestinal hemorrhage (the less the times, the black will be diluted dry) Pulse, normal blood pressure, color