Résumé
Peptic ulcer bleeding is the most common cause of upper gastromtestinal bleeding. The efficacy of local injection of hypertonic saline-epinephrine(RS-E)solutiom around the base of the bleeding vessels under endoscopy was assessed, During the period between January 1991 and August 1994, 83 patients with active bleeding or stigmata of recent hemorrhage in peptic ulcers were included to this study. The major cause of bleeding in this study consisted of gastric ulcers(60) and duodenal ulcers(23). Twenty patients rebled and seven required emergency surgery and two patients were died. Definitive hemoatasis was achieved in 74(89.3%). Two patients rebled due to mucosal ischemia induced by HS-E injection, other significant complication was not found. We conclude that the endoscopic injection with hypertonic saline-epinephrine solution is one of the effective and safe therapeutic modality in peptic ulcer bleeding.
Sujets)
Humains , Christianisme , Urgences , Endoscopie , Épinéphrine , Hémorragie , Ischémie , Ulcère peptique , UlcèreRésumé
Twenty-five patients presenting with severe hemorrhage from benign peptic ulcers were randomized to either endoscopic injection sclerosis using a combination of hypertonic saline- epinephrine solution and 5% ethanolamine or to hypertonic-saline epinephrine solution only. Only high risk patients with active bleeding or endoscopic stigmata of recent hemorrhage of ulcers were considered. A median duration of hospital admission and median transfusion requirements between the two types of treated groups were not significant difference. The initial hemestatic effects of HS-E solution injection group(n=l5) or combination of HS- E solution and 5% ethanolamine injection group(n=l0) were 93%, 90% respectively. The rebleeding rate of HS-E solution injection group(n =15) or combination of HS-E solution and 5% ethanolamine injection group(n=10) were 33%, 30%, respectively. So, both HS-E solution therapy group and comination of HS-E solution & 5% ethanolamine injection group were effective in initial hemostasis for bleeding peptic ulcer patients. However, for the further evaluation of therapeutic effect and comparison of rebleeding rate between the two types of therapy, we think that it will be indispensable to collect more cases and to compare with control group.