Mechanical endoscopic methods of haemostasis for bleeding peptic ulcers: a review.
Mechanical endoscopic methods of haemostasis for bleeding peptic ulcers: a review.
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DOI：
10.1053/bega.2000.0091
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发表时间：
2000-06
期刊：
影响因子：
--
通讯作者：
C. Hepworth;C. Swain
中科院分区：
文献类型：
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作者：
C. Hepworth;C. Swain
内镜治疗消化道出血后的再出血仍然很常见，可能是因为治疗出血的注射和热疗方法效果有限，特别是在存在大出血动脉的情况下。本章回顾了内窥镜止血的机械方法。可通过柔性内窥镜传送的夹子的设计通过其功效的实验和临床数据进行了审查。强调了改进夹子设计的必要性。介绍了各种其他机械止血方法的实验研究和初步临床数据，包括带子结扎、内环、缝纫机、吻合机、溃疡夹、开瓶器、球囊填塞和铁磁填塞。讨论了可能在溃疡止血中占有一席之地的新的、侵入性较小的手术方法，包括经胃腔内手术和伤口闭合的柔性内窥镜溃疡切除术。机械方法为改善消化性溃疡出血内镜止血的安全性提供了最佳前景。如果要改善结果，就需要更多的发展。
Re-bleeding following endoscopic therapy for gastrointestinal bleeding remains common probably because injection and thermal methods for treating bleeding are of limited efficacy, especially in the presence of a large bleeding artery. This chapter reviews mechanical methods of endoscopic haemostasis. The design of clips, which can be delivered through flexible endoscopes, is reviewed with experimental and clinical data of their efficacy. The need for improvements in clip design is stressed. Experimental studies and preliminary clinical data where available on a variety of other mechanical methods of haemostasis are presented, including band ligation, endoloops, sewing machines, stapling machines, ulcer clamps, corkscrews, balloon tamponade and ferromagnetic tamponade. New, less invasive, surgical methods which might have a place in ulcer haemostasis, including transgastric endoluminal surgery and flexible endoscopic ulcer excision with wound closure, are discussed. Mechanical methods offer the best prospect for improvements in security of endoscopic haemostasis for bleeding peptic ulcer. More development is required if the results are to improve.