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Endoscopic upper gastrointestinal bleeding spraying of fibrin sealant haemostasis clinical observation

Upper gastrointestinal bleeding in patients with endoscopic hemostatic fibrin sealant spray treatment, are as follows. 1 Data and methods 1.1 Clinical data of 18 cases of upper gastrointestinal bleeding, Mallory-Weiss sign 5 down, 4 cases of bleeding gastric ulcer, gastric polyp after transurethral resection plane surface bleeding in 3 cases. 3 cases of duodenal ulcer bleeding, esophagus and stomach with active bleeding after taking l pathological cases,[link widoczny dla zalogowanych], gastric ulcer bleeding after kissing the apron 1 case,[link widoczny dla zalogowanych], 1 postoperative bleeding at the guillotine closure. 1.2 The method uses 2.5ml fibrin sealant, with red and blue, respectively, the syringe pump of the main characters with the main rubber dissolved liquid mixture and the catalyst dissolved liquid mixture with the catalyst, will be fixed in the push to connect fluid needle seat conical head back. To speed up dissolution, you can shake a water bath at 37 ℃, pay attention to red after the solution preparation and preparation of the solution syringe needle after the syringe needle can not be mixed with blue characters, so as to avoid the formation of gel in advance. After finding the location of endoscopic bleeding, the bleeding sites with sterile distilled water, exposed to a clear vision,[link widoczny dla zalogowanych], to find the best location, first bio-plastic double-lumen delivery catheter inserted along the endoscope biopsy channel, first double-lumen catheter delivery Injection of small amounts of sterile distilled water, and patient position change, so that the lower part of the bleeding point in the delivery catheter to determine the catheter position of the liquid can drip to the bleeding surface, the outer end of delivery catheter to the lumen of the two lost population, while the syringe were injected into the red and blue has been prepared from the mixed solution,[link widoczny dla zalogowanych], in order to avoid gel blocking the endoscope, the delivery catheter to be inserted into the front lens from the 1.5-2.0era at endoscopy. Mixed solution in the syringe after all push, push the hollow catheter further 5ml of air, so that all the droplets of liquid within the duct to the bleeding site, its white surface can be formed fibrin gel. 1.3 Clinical criteria to all patients after treatment for the effect of the following criteria: (1) stable blood pressure, heart rate <100 beats / min; (2) will be negative for occult blood; (3) endoscopy confirmed the bleeding stops found ( 1), (2) or (1), (3) to believe that bleeding stops. Bleeding within 24 hours were as markedly, bleeding within 72 hours were valid, there is still bleeding after 72 hours, blood pressure fluctuations or require surgery to be invalid. Markedly increase the total effective and efficient. [Liu Yongge, et al. Endoscopic treatment of sprayed fibrin sealant clinical observation of lower gastrointestinal bleeding. Journal of Clinical Gastroenterology, 2002; 06:256]. 2 results of l8 patients, 2 cases of gastric ulcer bleeding as invalid, a bleeding duodenal ulcer as a valid feed, and the remaining 15 cases were markedly effective rate was 89%. 3 Discussion of endoscopic treatment of upper gastrointestinal bleeding is now the preferred method of clinical, endoscopic available ligation, injection sclerotherapy, electrocoagulation, titanium clip, epinephrine injection, spraying fibrin closed agent to treat a variety of methods , different situations hemostasis of bleeding can choose different methods. Fibrin sealant (fibrin glue that is) is a proper proportion of fibrinogen, coagulation serine protease, Ⅲ factor, calcium ions and other components were uniformly mixed in each group after the simulation of human physiological clotting mechanism. White fibrin gel formation. The gel can effectively inhibit the tissue sections and the small venous bleeding bleeding, closed defect tissue, promote wound healing and prevent tissue adhesion. Observation from this group fell ill, we can see slow for bleeding, particularly in patients with bleeding wounds on the organization, for endoscopic spraying of fibrin sealant for hemostasis, and the effect is more precise, easy to operate, suitable for various hospitals. For esophageal and gastric variceal bleeding, Dieulafoy disease and other bleeding more acute situation of a large amount of bleeding. Spraying of fibrin sealant haemostasis ineffective. Bleeding gastric ulcer bleeding in this group of patients is not valid with small arterial bleeding ulcer is the result, select the appropriate cases, endoscopic hemostasis spraying of fibrin sealant is an effective, simple and quick method. (This editorial Liu LSD)

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