| 特集名 | 胃潰瘍診療ガイドラインをめぐって | |
|---|---|---|
| 題名 | 消化管出血の治療 (1) 内視鏡治療 | |
| 発刊年月 | 2004年 02月 | |
| 著者 | 若林 貴夫 | 藤田保健衛生大学第二病院内科 |
| 著者 | 芳野 純治 | 藤田保健衛生大学第二病院内科 |
| 【 要旨 】 | 出血性胃潰瘍に対する内視鏡治療のステートメント． 1．内視鏡止血は噴出性出血，湧出性出血，露出血管を有する例が適応となる (グレードA，レベルI)． 2．これらの出血性潰瘍に内視鏡止血を加えることは，内科的治療単独に比べ初回止血および再出血の予防，手術移行の面で明らかに有用である (グレードA，レベルI)． 3．内視鏡止血の方法で初回止血および再出血の予防効果は，多くの成績において差が認められない (グレードA，レベルI)． 4．外科手術の適応は内視鏡で止血のできない出血性潰瘍である．60歳以上の高齢者では，外科手術の適応は早期に決定したほうがよい (グレードB，レベルII)． |
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| Theme | Guideline for Medical Practice of Gastric Ulcers | |
|---|---|---|
| Title | Guideline for Statement on Endoscopic Hemostasis for Bleeding Gastric Ulcers | |
| Author | Takao Wakabayashi | Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine |
| Author | Junji Yoshino | Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine |
| [ Summary ] | Statement about endoscopic hemostasis for bleeding gastric ulcer. 1. Endoscopic hemostasis is more effective both in patients with active bleeding and those with nonbleeding, visibles vessels (grade A, level I). 2. Compared to the control group, it was more useful to employ endoscopic hemostasis procedures after initial treatment, for prevention of recurrence of bleeding and avoiding emergency surgery, for patients considered to be grade A, level I. 3. There was no difference noted between results achieved with the many endoscopic hemostasis methods, after initial treatment in terms of prevention of recurrance of bleeding (grade A, level I ). 4. Patients with continuous bleeding after all endoscopic procedures have been performed must have surgical operations. For patient over sixty, an aggressive surgical policy is associated with a significant reduction in mortality (grade B, level II). |
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