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目的 :评价内镜下注射硬化剂治疗Dieulafoy病出血的疗效 ,并探讨其再出血的原因。方法 :回顾性分析我科 1 996年 3月～ 2 0 0 2年 1月行上消化道急诊内镜并行内镜下硬化剂注射治疗的Dieulafoy病病人。结果 :35例Dieulafoy病出血的患者 (男 2 5例 ,女 1 0例 ,平均年龄 48.8± 1 6 .2 ,范围 1 9～ 74岁 )均实施了注射硬化治疗 (内镜确诊后环绕血管残端或注血点注射 5 %鱼肝油酸钠 3～ 4点 ,每点 1 .0ml,有活动性出血者再对出血点注射 1 .0ml)。内镜下硬化剂治疗成功率 85 .7% ,4例 (1 1 .4 % )病人内镜治疗失败转外科手术治疗。所有经内镜止血的病人总死亡率 8.57% (3/ 35)。 32例存活的病人在长期随访中无 1例再出血 (平均 3 .8年 )。结论 :内镜下注射硬化剂治疗Dieulafoy病出血安全有效的方法 ,减少了对外科治疗的需求并明显降低了死亡率
OBJECTIVE: To evaluate the efficacy of endoscopically injected sclerotherapy in the treatment of Dieulafoy’s hemorrhage and to investigate its causes of rebleeding. Methods: A retrospective analysis of our department from March 1996 to January 2002 2002 emergency endoscopic upper gastrointestinal endoscopic sclerotherapy in patients with Dieulafoy disease. RESULTS: Thirty-five patients with Dieulafoy’s disease (25 males and 10 females with an average age of 48.8 ± 16.2 and range of 19 to 74 years) were treated with injection sclerotherapy End or injection point injection of 5% sodium morrhuate 3 to 4 points, each point 1.0ml, active bleeding and then to the bleeding point injection 1 .0ml). Endoscopic sclerotherapy success rate of 85.7%, 4 patients (11.4%) failed to endoscopic treatment of surgical treatment. The total mortality of all endoscopic hemostasis patients was 8.57% (3/35). None of the 32 surviving patients had rebleeding (mean, 3.8 years) during long-term follow-up. CONCLUSION: Endoscopic injection of sclerotherapy is safe and effective in the treatment of bleeding from Dieulafoy’s disease, reducing the need for surgical treatment and significantly reducing mortality