内镜下组织胶注射术治疗急性出血性直肠溃疡综合征1例并文献复习

Endoscopic Tissue Glue Injection for Acute Hemorrhagic Rectal Ulcer Syndrome: A Case Report and Literature Review

摘要: 目的：探究急性出血性直肠溃疡综合征(AHRUS)临床特点及内镜下组织胶注射治疗效果。方法：报告青岛大学附属医院消化内科收治的1例急性出血性直肠溃疡综合征的病例，回顾性分析该患者的临床及内镜下特点，及其内镜下治疗结果。结果：患者为中年女性，便血1周急诊入院，失血较多呈昏迷状态，血红蛋白71 g/L，内镜下表现为急性出血性多发直肠溃疡，经药物保守治疗后仍出血不止，给予急诊内镜下组织胶注射止血成功，随访1年半均未再出血。结论：急性出血性直肠溃疡综合征在临床工作中虽少见但病情危重，多以局部对症治疗为主，本例患者内镜下组织胶注射止血效果好，痛苦少，内镜下治疗对AHRUS患者的临床转归具有非常重要的意义。

Abstract: Objective: To explore the clinical features of acute hemorrhagic rectal ulcer syndrome (AHRUS) and the therapeutic effect of endoscopic tissue glue injection. Methods: A case of acute hemorrhagic rectal ulcer syndrome admitted to the Department of Gastroenterology, Affiliated Hospital of Qingdao University was reported. The clinical and endoscopic characteristics of the patient and the results of endoscopic treatment were retrospectively analyzed. Results: The patient was a middle-aged female with hematochezia for one week and was admitted to the emergency hospital in a coma with heavy blood loss and hemoglobin of 71 g/L. The patient showed acute hemorrhagic multiple rectal ulcers under the endoscope, and the bleeding continued after conservative treatment with drugs. The hemostasis was successfully stopped by the injection of tissue glue under the emergency endoscope, and no further bleeding occurred during the follow-up of one and a half years. Conclusion: Although acute hemorrhagic rectal ulcer syndrome is rare in clinical work, the condition is critical, and local symptomatic treatment is mainly used. In this case, endoscopic tissue glue injection has good hemostatic effect and less pain, and endoscopic treatment is of great significance for the clinical outcome of patients with AHRUS.