食管-贲门黏膜撕裂综合征诊断与治疗

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目的探讨食管-贲门黏膜撕裂综合征(Mallory-Weiss综合征)的临床特点、诊断和治疗方法。方法回顾性分析101例Mallory-Weiss综合征患者的临床资料,比较保守治疗患者和内镜治疗患者的诱因、住院时间、输血量和再出血发生率等。结果 46例患者接受保守治疗(保守组),其中31例一期治愈,15例经保守治疗后再出血经内镜治疗治愈;51例患者经内镜治疗一期治愈(内镜组);4例手术治疗,其中3例治愈,1例死亡;Mallory-Weiss综合征占同期上消化道出血的7.79%,剧烈呕吐是主要诱因,上消化道出血是主要症状,急诊内镜是主要检查方法;内镜组住院时间[(7.1±1.5)d]、输血量[(296.1±99.4)mL]和再出血发生率(0)均低于保守组[(11.8±2.3)d、(652.2±196.1)mL、32.6%](P<0.05),性别比例、年龄、诱因和病死率与保守组比较差异均无统计学意义(P>0.05)。结论 Mallory-Weiss综合征以呕吐后消化道出血为主要临床特点,急诊内镜是主要检查治疗方法。 Objective To investigate the clinical features, diagnosis and treatment of esophageal-gastric mucosal tearing syndrome (Mallory-Weiss syndrome). Methods The clinical data of 101 patients with Mallory-Weiss syndrome were retrospectively analyzed. The causes, duration of hospitalization, blood transfusion, and the incidence of rebleeding were compared between conservative treatment and endoscopic treatment. Results 46 cases received conservative treatment (conservative group), of which 31 cases were cured in the first phase and 15 cases were cured by conservative treatment. Endoscopic therapy was used to treat the bleeding in 51 cases; endoscopic treatment was used in 51 cases (endoscopic group); 4 Cases of surgical treatment, of which 3 cases were cured, 1 case died; Mallory-Weiss syndrome accounted for 7.79% of upper gastrointestinal bleeding in the same period, severe vomiting is the main cause of upper gastrointestinal bleeding is the main symptom, the main method of emergency endoscopy; The length of hospital stay was (7.1 ± 1.5) days, the volume of blood transfusion (296.1 ± 99.4) mL and the incidence of rebleeding (0) were lower than those in the conservative group (11.8 ± 2.3 days, 652.2 ± 196.1 years, mL, 32.6%] (P <0.05). The sex ratio, age, predisposition and mortality were not significantly different from those in the conservative group (P> 0.05). Conclusion Mallory-Weiss syndrome is the main clinical feature of vomiting and gastrointestinal bleeding. Emergency endoscopy is the main method of examination and treatment.
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