消化道大出血急诊剖腹探查术中纤维内镜的应用研究

目的：探讨术中纤维内镜在消化道大出血急诊剖腹探查术中的应用价值．方法：对20例不明原因急性消化道大出血须急诊剖腹探查的患者进行术中内镜检查，总结和评价其应用价值．结果：19例患者通过术中内镜检查明确了出血部位及原因，其阳性检出率达95％．其中十二指肠降部单发腺瘤2例，十二指肠水平部Dieulafoy病1例，十二指肠淋巴瘤1例，空肠间质瘤2例，回肠淋巴瘤2例，小肠海绵状血管瘤5例，小肠动静脉畸形5例，胃空肠吻合口出血1例．检查用时15-20min．患者经术中内镜检查明确出血部位及原因后行相关手术治疗，术后无1例出现消化道再出血．结论：不明原因急性消化道大出血急诊剖腹探查时，术中内镜的应用大大提高病变检出率，及时明确出血部位而采取相应治疗，且定性准确、安全可靠．

Application Study of Intraoperative Endoscopy during the Emergency Exploratory Laparotomy in the Patients with Acute Massive Digestive Tract Bleeding

Objective： To evaluate the application of intraoperative endoscopy during emergency exploratory laparotomy in the patients with acute massive digestive tract bleeding. Methods： Twenty patients with acute massive digestive tract bleeding were examined by intraoperative endoscopy during the emergency exploratory laparotomy and the clinical data were analyzed. Results：The hemorrhagic sites and reasons of 19 patients were clarified in 20 patients （95%） through application of intraoperative endoscopy. The average examination time was 15-20 min and no complications related to intraoperative endoscopy occurred in all patients. Conclusion： The application of intraoperative endoscopy, which may increase the detection rate, is efficient and safe during the emergency exploratory laparotomy in the patients with acute massive digestive tract bleeding.