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目的评价内镜套扎治疗Dieulafoy病并发急性上消化道出血的有效性和安全性。方法 6例Dieulafoy病并发急性上消化道出血的患者,其中男性4例,女性2例,年龄35～67岁。采用内镜皮圈套扎治疗。5例病灶位于胃体或胃底,1例位于胃窦。采用多连发套扎器,通过负压抽吸,使Dieulafoy病灶及周围组织吸入套扎帽内,然后释放弹力皮圈将其结扎。结果 6例患者均获成功,6个月至4年后随访并复查胃镜,未再发上消化道出血,复查胃镜时6例套扎环均已脱落。其中3例病灶处形成溃疡瘢痕改变,另3例病灶完全消失,为正常胃黏膜。结论内镜皮圈套扎是治疗Dieulafoy病的一种安全、有效、经济的方法。具体方法可根据病灶特点和时机进行选择。
Objective To evaluate the efficacy and safety of endoscopic ligation in the treatment of Dieulafoy’s disease complicated with acute upper gastrointestinal bleeding. Methods Six patients with Dieulafoy’s disease complicated with acute upper gastrointestinal bleeding were enrolled. Among them, 4 were males and 2 females, aged 35-67 years old. Endoscopic dermatoplasty treatment. Five lesions were located in the gastric or gastric fundus, one in the antrum. With a multi-tiered ligation device, the Dieulafoy’s lesion and surrounding tissue are aspirated into the ligation cap by vacuum suction, and the elastic apron is then released to ligate it. Results All 6 patients were successful. Follow-up was performed from 6 months to 4 years after the gastroscope was performed. No upper gastrointestinal bleeding was found. All the ligation rings were absent when the endoscopy was performed. Three of the lesions formed ulcer scar change, the other three lesions completely disappeared, the normal gastric mucosa. Conclusion Laparoscopic ligation is a safe, effective and economical method for the treatment of Dieulafoy’s disease. Specific methods can be selected according to the characteristics and timing of lesions.