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目的:探讨吻合口溃疡出血的内镜特点和内科治疗效果。方法:回顾分析59例吻合口溃疡出血(研究组)和243例溃疡病出血(对照组)的内镜下Forrest分级及内科治疗的效果。结果:研究组10例多发溃疡,余为单发,共75个溃疡,位于吻合口、空肠侧及鞍部和胃侧分别是32％、40％和28％。其活动性出血(17％)和有的期出血征象(23.8％)显著多于对照组(8.2％,12.7％)。研究组输血量和住院天数显著高于对照组,而再出血、急诊手术和死亡率等两组间无显著差别。结论:抑酸剂结合内镜下注射可有效治疗吻合口溃疡出血,按照内镜下出血征象进行注射治疗可提高疗效。
Objective: To investigate the endoscopic features and medical treatment of anastomotic ulcer bleeding. Methods: A retrospective analysis of 59 cases of anastomotic ulcer bleeding (study group) and 243 cases of ulcer bleeding (control group) for the endoscopic Forrest classification and medical treatment effect. Results: In the study group, 10 patients had multiple ulcers, with more than 75 ulcers. The anastomosis was located at the anastomosis side. The jejunum, saddle and stomach were 32%, 40% and 28%, respectively. The rate of active bleeding (17%) and period bleeding (23.8%) were significantly higher than that of the control group (8.2%, 12.7%). The volume of blood transfusion and hospital stay in the study group was significantly higher than that in the control group, while there was no significant difference between the two groups in terms of rebleeding, emergency surgery and mortality. Conclusion: Antacids combined with endoscopic injection can effectively hemorrhage of anastomotic ulcer, and injection therapy according to the signs of endoscopic hemorrhage can improve the curative effect.