2012年 · 第32卷第02期

Indications for endoscopic treatment of early CRC include: ① intramucosal carcinoma with depth of invasion limited to the mucosal layer; ② Submucosal carcinoma with depth of invasion limited to superficial submucosa (sm1)^[98]。

In recent years, with the advancement of endoscopic technology, the treatment of upper gastrointestinal bleeding has made great progress, and its prognosis has improved significantly, and the mortality rate has decreased significantly. Although the recurrence rate of bleeding has decreased, the incidence of re-bleeding after the first endoscopic hemostasis remains high, reported to be 13%^[1]。 When the first endoscopic hemostasis fails, surgical treatment is a very effective measure. However, surgical treatment has more complications than repeated endoscopic treatment, and it is not the best choice for some patients, such as advanced age or other severe diseases who cannot tolerate surgery (this part of patients accounts for a large proportion of rebleeding patients).

The most effective treatment for non-varicose upper gastrointestinal bleeding is endoscopic hemostatic therapy. The Asia-Pacific expert consensus opinion on non-varicose upper gastrointestinal bleeding (hereinafter referred to as the Asia-Pacific consensus opinion) recommends no hospitalization for patients without serious comorbidities and low risk of endoscopic rebleeding; The timing of endoscopic hemostasis is clearly defined, but which patients need endoscopic hemostasis and the method of endoscopic hemostasis are not clearly stated. The Asia-Pacific consensus opinion emphasizes the need for combined use of proton pump inhibitors after endoscopic hemostasis. Routine endoscopic review is not recommended for patients with endoscopic hemostasis, but endoscopic review can be performed for patients with high risk of rebleeding. Patients who rebleed after endoscopic hemostasis may still consider re-endoscopic treatment or other treatment measures.