摘要目的：探讨内镜下乳头扩约肌切开术（EST）后迟发性出血的治疗效果。方法回顾性分析2638例行 EST 患者的临床资料，其中合并消化道出血患者26例（0．99%）。26例患者均行十二指肠镜检查，对活动出血者行内镜下止血治疗。结果26例患者中十二指肠乳头活动出血21例，出血已停止5例。其中切开部位普遍渗血12例，点状活动出血9例。12例普遍渗血者中行α-氰基丙烯酸正辛酯（TH 胶）喷洒治疗9例，局部注射110000去甲肾上腺素氯化钠溶液3例。9例点状活动出血病例中行金属钛夹治疗5例，氩离子凝固术治疗4例。全部患者一次治疗成功，无中转手术及死亡病例。结论十二指肠乳头括约肌切开术后，可有少量患者出现迟发性出血，急诊内镜下选用 TH 胶喷洒、局部注射、氩离子凝固及金属钛夹治疗方法可使大多数出血得到有效控制。

abstractsObjective To investigate the effect of endoscopic treatment of delayed hemorrhage after endoscopic sphincterotomy.Methods Retrospectively analyzed the data of 2 638 patients who underwent endoscopic sphincterotomy.There were 26 patients who delayed hemorrhage after endoscopic sphincterotomy.All the 26 patients underwent duodenoscopy,and endoscopic treatment was underwent for the patients who had active bleeding.Results There were 21 patients had active bleeding,and the other 5 cases had no bleeding.There were 12 patients with capillary hemorrhage and 9 cases with petechial hemorrhage.In the 12 patients with capillary hemorrhage,9 patients had been sprayed tissue glue,and 3 patients had been local injected with 1 10 000 noradrenalin.In the 9 patients with petechial hemorrhage,5 patients were treated with titanium clip,and 4 patients were treated with argon ion.All the 21 patients were crued,and no patient was operated and no patient died.Conclusion There are few patients who delayed hemorrhage after endoscopic sphincterotomy.Tissue glue sprayed,local injection,argon ion and titanium clip can cure the bleeding.