【摘要】 目的 探讨食管、胃切除术后上消化道大出血的原因及内镜下治疗的方法、效果。 方法 对食管、胃切除术后引起大出血的患者行急症内镜检查，用冰冻生理盐水100ml+去甲肾上腺素8mg反复冲洗，暴露出血部位后在病灶周围黏膜下注射1∶10000肾上腺素及高渗盐水，无出血后，退镜前于出血部位喷洒云南白药及凝血酶，防止再次出血。 结果 20例中只有1例因出血时间较多，约10天，胃内凝血块过多无法清除，无法找到出血灶转外科手术治疗，余19例均首次止血成功。 结论 黏膜下注射治疗消化道出血控制出血迅速有效，合并镜下喷洒云南白药、凝血酶防止再次出血，避免外科再次手术治疗。

    【关键词】 食管、胃切除术;上消化道大出血;内镜下注射治疗

    The clinical study of the course of massive hemorrhage of upper digestive tract af-ter esophagectomy and gastrectomy and its treatment under endoscope

    HE Li-juan，YE Yang-e，ZHUMan-ran，et al.

    Yuebei People's hospital，Shaoguan，Guangdong512026，Chi-na

    【Abstract】 Objective To discuss the methods and effects of the treatment under endoscope and the courses of massive hemorrhage of upper digestive tract after gastrectomy and esophagectomy.Methods Emergency endoscope ex-amination were carried out in20massive hemorrhage clients after gastrectomy and esophagectomy ......