Curative Observation Of The Treatment With Metal Titanic Clip Combined With Epineph-rine Injection On Dieulafoy’s Lesion Under Endoscope

Objective To explore the clinical curative effect of the treatment with metal titanic clip combined with epinephrine injection therapy of Dieulafoy’ s lesion.Methods A retrospective analysis was made to the clinical data of 42 cases with confirmed diagnosis of Dieulafoy’ s lesion by endoscope from Jan.1st,2007 to Mar.31st,2016 in Changzhou No.2 People’s Hospital Affilated to Nanjing Medical University;they were divided into 2 groups:the observation group and the control group,hemostatic treatment with mental titanic clip combined with epinephrine injection was performed to cases in the observation group under endoscope while argon plasma coagulation and epinephrine injection was performed to cases in the control group under endoscope.Hemostatic success rate for the first time,reoccurrence rate of bleeding and the rates of surgery between two groups were compared.Results In the observation group,20 cases were treated with the mental titanic clip combined with epinephrine injection for only 1 time.Initial hemostasis in endoscopic the observation group is 100%,There was no postoperative bleeding,Length of hospital stay between 10-14 days.No treatment-related side effects were found.In the control group,22 cases were treated with the argon plasma coagulation and epinephrine injection,Initial hemostasis in endoscopic the control group is 90.9%,Rebleeding rate was 18.2%.There are second times of endoscopic argon plasma coagulation combined with epinephrine injection in the treatment of 2 cases of bleeding after stop.But there are 2 patients undergoing endoscopic argon plasma coagulation combined with epinephrine injection after treatment of recurrent hemorrhage,Finally 2 patients underwent surgical hemostasis successfully.Length of hospital stay between 10-22 days.No treatment-related side effects were found.There were no significant differences in the hemotatic success rate for the first time and the rate of surgery between two groups(P>0.05);but there was significant difference in the reoccurrence rate of bleeding(P<0.05).Conclusion Endoscopic metal titanic clip joint epinephrine injection in the treatment of Dieulafoy’ s lesion has higher initial hemostasis success rate,lower recurrent bleeding rate and conversion rate,and is an ideal treatment forDieulafoy disease..