Korean J Gastrointest Endosc > Volume 20(6); 2000 > Article

Korean Journal of Gastrointestinal Endoscopy 2000;20(6): 431-436.

원저 : 소화성 궤양 출혈에서 열탐침 지혈법 후 재출혈의 위험인자 (The Risk Factors for Rebleeding with Heat Probe Thermocoagulation in Bleeding Peptie Ulcer Patients

이상구(Sang Goo Lee),손희정(Hee Jung Son),김영호(Young Ho Kim),류광현(Gwang Hyun Ryu),이석호(Suk Ho Lee),이종균(Jong Kyun Lee),이준혁(Joon Hyoek Lee),이규택(Kyu Taek Lee),이풍렬(Poong Lyul Lee),김재준(Jae J. Kim),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi)

Abstract

Background/Aims:
The precise rebleeding rate and risk factors of rebleeding after heat probe thermocoagulation in peptic ulcer patients with bleeding are not clear and still need to be evaluated. If we could identify the pre-dictors for rebleeding, the mortality rate might be loweted with early retreatment or surgery in these high risk group.
Methods:
The 94 patients in whom heat probe was applied were enrolled and the 18 patients with bleeding tendencies. Initial hemostasis was defined as hemostasis persisting for 24 hours post-treatment and permanent hemostasis as absence of bleeding for 7 days after therapy. Rebleedig was defined as oozing or spurting hemorrhage in the ulcer base and/or unstable vital signs and continuting tarry or bloody stool or hematemesis after therapy.
Results:
In 35 patients with active bleeding sign, initial hemostasis was obtained in 30 (85.7%) patients. After having achieved initial hemostasis, 9 (30.0%) patients rebled. In 41 ulcer patients with non-bleeding visible vessel, 40 cases (97.6%) achieved successful pre-vention of rebleeding. No evident complication was observed. With univariate analysis, bleeding ulcer patients with spurting and oozing hemorrhage had a higher re-bleeding rate than those with non-bleeding visible vessel.
Conclusions:
The heat probe thermocoagulaton is relative safe and effective procedure to protect bleeding in pectic ulcer patients with non-bleeding visible vessel, but insufficient to hemostasis in bleeding peptic ulcer patients with spurting or oozing in ulcer base. Spurting and oozing hemorrhage are the only risk factors of rebleeding after initial hemostasis with heat probe thermocoagulation in peptic ulcer patients with bleeding.

Key Words: Peptic ulcer, Rebleeding, Risk factor, Heat probe thermocoagulation, 소화성 궤양, 재출혈, 위험 인자, 열탐침 지혈법