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目的评价经内镜皮圈套扎(EBL)治疗Dieulafoy病变出血的疗效及安全性。方法对31例Dieulafoy病出血患者随机采用EBL(n=16)或硬化剂注射(EIS,n=15)治疗,20例患者病灶位于胃,8例位于胃肠吻合口,3例位于十二指肠球部。EBL组采用多连发套扎器,通过负压抽吸,使Dieu lafoy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。EIS组选用5%鱼肝油酸钠或1%乙氧硬化醇,绕Dieulafoy病灶周围注射止血。结果EBL组套扎组织在内镜治疗后3～7d内脱落;EBL组早期止血率、远期止血率和转外科手术率均与EIS组相似(分别为93.8%比86.7%,100.0%比86.7%,0比13.3%;P值均>0.05),但再出血率显著低于EIS组(6.3%比40.0%,P<0.05);EBL组并发症发生率为6.3%,EIS组为6.7%,差异无统计学意义(P>0.05)。结论EBL是内镜治疗Dieulafoy病变出血一种安全和有效的方法。
Objective To evaluate the efficacy and safety of endoscopic dermal ligation (EBL) in the treatment of Dieulafoy’s disease. Methods Thirty-one patients with Dieulafoy’s disease were randomized to receive EBL (n = 16) or sclerotherapy (n = 15). Twenty patients were located in the stomach, eight in the gastrointestinal anastomosis, and three in the duodenum Department of bowel. In the EBL group, a multi-ligature ligation device was used to suck the Dieu lafoy’s lesion and surrounding tissue into the ligation cap by suctioning under negative pressure, and then releasing the stretch apron to ligate it. EIS group choose 5% sodium heparinate or 1% ethoxylated alcohol, around the injection of Dieulafoy lesions stop bleeding. Results The ligation of the EBL group within 3 to 7 days after endoscopic treatment was successful. The rates of early hemostasis, long-term hemostasis and surgical procedures in EBL group were similar to those in EIS group (93.8% vs. 86.7%, 100.0% vs. 86.7 %, 0%, 13.3%, P> 0.05), but the rate of rebleeding was significantly lower than that of EIS group (6.3% vs 40.0%, P <0.05). The incidence of complications in EBL group was 6.3% , The difference was not statistically significant (P> 0.05). Conclusion EBL is a safe and effective method for the endoscopic treatment of bleeding in Dieulafoy’s disease.