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首页> 外文期刊>Current treatment options in gastroenterology >Endoscopic treatment of ulcer bleeding.
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Endoscopic treatment of ulcer bleeding.

机译：内镜治疗溃疡出血。

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摘要

Upper gastrointestinal (UGI) bleeding secondary to ulcer disease occurs commonly and results in significant patient morbidity and medical expense. After initial resuscitation, carefully performed endoscopy provides an accurate diagnosis of the source of the UGI hemorrhage and can reliably identify those high-risk subgroups that may benefit most from endoscopic hemostasis. Large-channel therapeutic endoscopes are recommended. Endoscopists should be very experienced in management of patients with UGI hemorrhage, including the use of various hemostatic devices. For patients with major stigmata of ulcer hemorrhage--active arterial bleeding, nonbleeding visible vessel, and adherent clot--combination therapy with epinephrine injection and either thermal coaptive coagulation (with multipolar or heater probe) or endoclips is recommended. High-dose intravenous proton-pump inhibitors are recommended as concomitant therapy with endoscopic hemostasis of major stigmata. Patients with minor stigmata or clean-based ulcers will not benefit from endoscopic therapy and should be triaged to less intensive care and be considered for early discharge. Effective endoscopic hemostasis of ulcer bleeding can significantly improve outcomes by reducing rebleeding, transfusion requirement, and need for surgery, as well as reduce cost of medical care.
机译：溃疡病继发的上消化道（UGI）出血普遍发生，并导致大量患者发病和医疗费用。进行初步复苏后，精心进行的内窥镜检查可准确诊断UGI出血的来源，并可可靠地识别出那些可从内窥镜止血中获益最多的高危亚组。建议使用大通道治疗内窥镜。内镜医师应在处理UGI出血患者（包括使用各种止血装置）方面有丰富的经验。对于溃疡性出血的主要污名患者-活动性动脉出血，可见血管无出血和血栓附着-建议联合肾上腺素注射和热结缔凝（多极或加热器探针）或内窥镜联合治疗。推荐使用大剂量静脉内质子泵抑制剂作为伴有内镜下止血的主要污点治疗。患有轻度污点或基于清洁的溃疡的患者将无法从内窥镜治疗中受益，应分诊至重症监护，并考虑尽早出院。溃疡出血的有效内窥镜止血可以通过减少再出血，输血需求和手术需求来显着改善结局，并降低医疗费用。

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