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目的探讨急诊内镜下使用止血夹治疗消化道机械吻合术后早期吻合口出血的疗效。方法回顾性分析2005年1月至2016年12月期间在笔者所在医院胃肠外科接受内镜下止血的12例消化道机械吻合术后早期吻合口出血患者的临床资料。结果本组12例患者中,10例患者一次止血成功;2例出现再次出血,其中1例再次内镜下止血成功,1例胃空肠吻合术后患者止血失败、行手术治疗。所有患者术后均未出现吻合口漏等严重并发症。术后11例内镜止血成功患者获访6~28个月,中位随访时间18个月,随访期间未见再次出血。结论急诊内镜下止血夹治疗消化道机械吻合术后早期吻合口出血的操作简单、安全及有效,可作为首选方法在临床上推广应用。
Objective To investigate the efficacy of emergency endoscopic treatment of hemostatic clip in the treatment of anastomotic bleeding after mechanical anastomosis of digestive tract. Methods The clinical data of 12 patients with anastomotic bleeding after mechanical anastomosis of gastrointestinal tract underwent endoscopic hemostasis in our hospital from January 2005 to December 2016 were analyzed retrospectively. Results Of the 12 patients in this group, 10 patients had a successful hemostasis; 2 patients had hemorrhage again. One patient underwent successful endoscopic hemostasis and one patient undergone gastrojejunostomy failed hemostasis. Surgical treatment was performed. All patients had no serious complications such as anastomotic leakage after operation. Eleven patients with successful endoscopic hemostasis were followed up for 6-28 months, with a median follow-up of 18 months. No recurrence of bleeding was observed during follow-up. Conclusion Emergency endoscopic hemostatic clip in the treatment of early anastomotic bleeding after mechanical anastomosis of the digestive tract is simple, safe and effective and can be used as the first choice in clinical practice.