摘要目的 探讨单通道内镜下尼龙绳联合止血夹荷包缝合术治疗消化性溃疡并出血的疗效及安全性.方法 回顾性分析2015年1月1日至2018年1月1日在本院因消化性溃疡并出血而住院行急诊电子胃镜检查,并完成单通道内镜下尼龙绳联合止血夹荷包缝合术治疗的患者的基本信息、临床资料、手术记录及术后并发症与转归情况,并对所有纳入研究的患者进行随访,获取患者术后复查胃镜的具体结果.结果 最终有16例患者纳入本研究,其中消化性溃疡位于胃角6例、胃窦3例、胃体部3例、十二指肠球部及胃底各2例.溃疡最大面积40 rnm×25 mm,直径(23.0 ±6.0)mm.所有患者行单通道内镜下尼龙绳联合止血夹荷包缝合术完全闭合溃疡创面,其中1例十二指肠球部溃疡患者出现术后出血,转本院介入科止血成功.其余15例均未再出血.l例胃窦、1例胃底患者确诊为中分化腺癌,内镜下止血成功后择期手术胃窦癌根治术治疗.结论 单通道内镜下尼龙绳联合止血夹荷包缝合术是巨大消化性溃疡并出血的安全、有效治疗方法,值得临床推广,特别是对于那些深大且有穿孔风险的溃疡灶,优势更加明显.

abstractsObjective To investigate the efficacy and safety of single-channel endoscopic nylon rope combined with hemostatic clip suture in the treatment of peptic ulcer and bleeding.Methods Patients in our hospital due to peptic ulcer bleeding and hospitalization emergency electronic endoscopy from January 1st,2001 to July 1st,2017 were enrolled in the study.They were treated the single-channel endoscopic nylon rope combined with hemostatic clip suture.The basic information,clinical data,surgical records combined and retrospective analysed.Results 16 patients were included in the study.Among all the patients,peptic ulcer was located in 6 cases of gastric angle,3 cases of gastric antrum,3 cases of gastric body,2 cases of duodenal bulb and stomach.Ulcer maximum 40 mm × 25 mm,an average of (23.0 ± 6.0) mm.All ulcer wounds in patients underwent single-channel endoscopic nylon rope combined with hemostatic clip pouch suture were completely closed,including 1 case of duodenal ulcer patients after bleeding,achieved hemostasis successfully when turned into our hospital intervention.The remaining 15 cases were no longer bleeding.1 cases of gastric antral and 1 cases of stomach were diagnosed as moderately differentiated adenocarcinoma and they received endoscopic resuscitation after successful elective surgery gastric antral cancer radical surgery.Conclusions Single channel endoscopic nylon rope combined with hemostatic clip sacking is a safe and effective method for the treatment of giant peptic ulcer and bleeding.It is worthy of clinical manifestation,especially for those with deep and perforated ulcer.