| 비정맥류 비궤양성 상부위장관 출혈에서 내시경 밴드 결찰술과 전기 응고법의 치료효과 |
| 김화민·구양서·정문기·김영남·임도윤·권광안·박동균·김선숙·김연석·권소영·김유경·최덕주·김주현 |
| 가천의과대학교 내과학교실 |
| Endoscopic Treatment with Band Ligation and Electrocoagulation for Non-Variceal, Non-Ulcer Upper Gastrointestinal Bleeding |
| Hwa Min Kim, M.D., Yang Suh Ku, M.D., Moon Gi Chung, M.D., Young Nam Kim, M.D., Do Yoon Lim, M.D., Kwang An Kwon, M.D., Dong Kyun Park, M.D., Sun Suk Kim, M.D., Yeon Suk Kim, M.D., So Young Kwon, M.D., Yu Kyung Kim, M.D., Duck Joo Choi, M.D. and Ju Hyun K |
| Department of Internal Medicine, Gachon Medical School, Gil Medical Center, Incheon, Korea |
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| Abstract |
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Background/Aims:
This study compared the therapeutic efficacy of endoscopic band ligation (EBL) with that of electrocoagulation for treating non-variceal, non-ulcer (NVNU) upper gastrointestinal (UGI) bleeding.
Methods:
This study included 89 patients who underwent EBL and 56 patients in whom monopolar electrocoagulation was performed for NVNU UGI bleeding. The lesions treated were Mallory-Weiss tear in 91 patients, Dieulafoy's lesion in 42 patients and angiodysplasia in 12 patients.
Results:
The initial hemostatic rate was 97% in the EBL group and 91% in the electrocoagulation group, but this was not statistically different. Rebleeding occurred in 5 of 89 patients (5.6%) in the EBL group and in 8 of 56 patients (14.3%) in the electrocoagulation group (p=0.07). Thrombocytopenia or prothrombin time prolongation was confirmed to be a significant risk factor for rebleeding. The rebleeding rate in the high risk group was significantly lower than in the EBL group (9% vs. 30%, respectively, p=0.03). The median procedure time was significantly shorter in the EBL group compared with that in the electrocoagulation group (median 5.6 minutes vs. 8.3 minutes, respectively, p=0.04).
Conclusions:
EBL and electrocoagulation are both effective for treating NVNU UGI bleeding, and EBL is especially safe and effective for the cases with a high risk for rebleeding. (Korean J Gastrointest Endosc 2006;33:6976) |
| Key Words:
Gastrointestinal bleeding, Endoscopic band ligation, Electrocoagulation |
| 주요어:
위장관 출혈, 밴드 결찰술, 전기응고법 |
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