[Effectiveness of emergency endoscopic sclerosis in the control of digestive hemorrhage caused by gastroduodenal ulcer].

A Lanas, J L Alonso, I Alberdi, A Cornago, R Trujillo, M Lachen
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Abstract

An investigation was made of the effect of emergency endoscopic sclerotherapy on the evaluation of digestive hemorrhage (HDA) secondary to gastroduodenal ulcer disease in two consecutive groups of patients. The control group included 92 patients and the sclerotherapy group contained 63. Both groups had the same management and basic treatment of hemodynamic stabilization, anti-H2 agents and alkaline . The sclerotherapy group also received a local injection of 1/10,000 (5-12 ml) adrenaline and 1% polydocanol (5-12 ml) if direct signs of hemorrhage (active bleeding, red clot, visible vessel) were seen at the time of early endoscopy. Surgery was indicated in the presence of persistent, recurrent or massive digestive hemorrhage. Thirty-two percent of the control group and 34% of the sclerosis group presented direct signs of hemorrhage at the time of endoscopy. Both groups were homogeneous with respect to sex distribution, NSAID intake, hemoglobin, presence of shock and etiology (33.3% and 36.3%, respectively, had duodenal ulcer). The average age was significantly higher in the control group than in the sclerotherapy group. Neither the presence of any endoscopic sign nor etiology contributed to the evolution of digestive bleeding. It is concluded that emergency endoscopic sclerotherapy with injection of adrenaline and polydocanol has a clearly favorable effect on the evolution of bleeding secondary to gastrointestinal ulcer disease evidencing direct signs on endoscopy.

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急诊内镜硬化治疗胃十二指肠溃疡消化道出血的疗效观察
对连续两组患者进行急诊内镜硬化治疗对胃十二指肠溃疡继发消化性出血(HDA)的评价效果进行了研究。对照组92例,硬化治疗组63例。两组均采用血流动力学稳定、抗h2药物和碱性治疗。硬化治疗组如在早期内镜检查时发现直接出血征象(活动性出血、红血块、可见血管),局部注射1/ 10000 (5-12 ml)肾上腺素和1%聚多酚(5-12 ml)。手术是指存在持续性,复发性或大量消化道出血。32%的对照组和34%的硬化症组在内窥镜检查时出现出血的直接迹象。两组在性别分布、非甾体抗炎药摄入量、血红蛋白、休克和病因方面均相同(分别为33.3%和36.3%)。对照组的平均年龄明显高于硬化治疗组。消化道出血的发生与内窥镜征象和病因都没有关系。由此可见,急诊内镜下注射肾上腺素和聚多卡因硬化治疗对胃溃疡继发性出血的发展有明显的有利作用,胃镜检查有直接体征。
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