机械通气时急诊内镜辅助三腔二囊管治疗失血性休克的食管静脉曲张出血患者临床观察

肝脏 ›› 2020, Vol. 25 ›› Issue (8): 797-799.

机械通气时急诊内镜辅助三腔二囊管治疗失血性休克的食管静脉曲张出血患者临床观察

张军昌, 林芳, 陈素红, 牟劲松

100039 北京解放军总医院第五医学中心重症医学中心

收稿日期:2020-02-20 出版日期:2020-08-31 发布日期:2020-09-04
通讯作者: 牟劲松,Email:Jinsongmu@126.com

Clinical effect of triple-lumen and two-capsule catheter assisted by emergency endoscopy in the treatment of esophageal gastric varices bleeding in patients with hemorrhagic shock and under mechanical ventilation

ZHANG Jun-chang, LIN Fang, CHEN Su-hong, MU Jin-song

Critical Care Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China

Received:2020-02-20 Online:2020-08-31 Published:2020-09-04
Contact: Mu Jin-song, Email: Jinsongmu@126.com

摘要/Abstract

摘要： 目的探讨在机械通气时急诊内镜辅助三腔二囊管置入治疗失血性休克的食管胃底静脉曲张破裂出血的效果。方法选择解放军总医院第五医学中心重症医学中心2017年5月至 2019年3月收治的15例失血性休克患者作为研究对象。结果 15例失血性休克患者在机械通气时内镜下止血或置入三腔二囊管治疗均失败。采用急诊内镜下辅助三腔二囊管置入均成功。12例止血效果确切,1例病情稳定后成功行经颈静脉肝内门静脉分流术(TIPS)成功止血,2例临床死亡。结论失血性休克患者在机械通气行内镜下止血或三腔二囊管置入治疗失败时,急诊内镜辅助三腔二囊管治疗食管胃底静脉曲张破裂出血成功率高,止血效果确切,可在临床上予以推广实施。

关键词: 食管胃底静脉曲张, 三腔二囊管, 急诊内镜

Abstract: Objective To explore the clinical effect of triple-lumen and two-capsule catheter assisted by emergency endoscopy in the treatment of ruptured esophageal and gastric varices bleeding with hemorrhagic shock during mechanical ventilation. Methods fifteen patients with ruptured esophageal and gastric varices bleeding admitted in our hospital from May 2017 to March 2019 were selected as the research objects. Results in 15 patients with hemorrhagic shock, endoscopic hemostasis or insertion of the three-chamber and two-sac tubes during mechanical ventilation failed. insertion of triple-lumen and two-capsule catheter assisted by emergency endoscopy was successful. The hemostatic effect was definite in 12 cases. 1 cases were successfully treated with emergency Tips to stop the bleeding when their condition was stable. 2 cases died clinically. Conclusion The treatment of ruptured esophageal and gastric varices bleeding with triple-lumen and two-capsule catheter assisted by emergency endoscopy has a high success rate,the hemostatic effect is definite, it can be popularized and implemented in clinic.

Key words: Esophageal and gastric varices, Triple-lumen and two-capsule catheter, Emergency endoscopy

张军昌, 林芳, 陈素红, 牟劲松. 机械通气时急诊内镜辅助三腔二囊管治疗失血性休克的食管静脉曲张出血患者临床观察[J]. 肝脏, 2020, 25(8): 797-799.

ZHANG Jun-chang, LIN Fang, CHEN Su-hong, MU Jin-song. Clinical effect of triple-lumen and two-capsule catheter assisted by emergency endoscopy in the treatment of esophageal gastric varices bleeding in patients with hemorrhagic shock and under mechanical ventilation[J]. Chinese Hepatolgy, 2020, 25(8): 797-799.

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