探讨内镜下构建急性上消化道出血的活体猪模型的可行性，验证在超级微创内镜下急诊止血培训中的应用价值。

术前对小型猪进行抗栓预处理，采用黏膜下剥离法(ESD)和内镜下黏膜套扎切除法(EMR-L)的方法构建出血模型。通过开展手把手急诊内镜下止血培训，2名内镜医师和12名学员分别对模型进行评价(4分制Likert量表)。

5头雌性小型猪，共构建36个胃溃疡，平均(7.2±0.8)个/头。所有胃溃疡均成功构建出血模型，成功率为100%，且均为Forrest Ib型出血。36个溃疡，标本平均大小0.7～3.5(2.3±0.9)cm，平均用时2～14(6.8±3.1)min。其中，ESD法24个、EMR-L法12个。内镜医师评估溃疡相似度、出血相似度以及模型满意度，得分为3.3±0.8、3.5±0.7和3.8±0.5。12名学员进行内镜下急诊止血培训，通过培训，学员的急诊止血理论和操作能力，明显提高(1.9±0.5 vs 3.6±0.4，P<0.05)。

内镜下构建急性上消化道出血的活体猪动物模型，是简单、可行的，且用时少，成功率和相似度高、可重复性强等特点。该模型有助于学员快速掌握急诊止血操作技能，在内镜教学和培训中具有较好的应用价值。

To explore the feasibility of a live porcine model for acute upper gastrointestinal bleeding, and validate its role for training in endoscopic super-minimally invasive hemostasis.

Animals were pre-administered clopidogrel, aspirin and unfractionated heparin. Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection with a ligation device (EMR-L), was used to create gastric ulcers with bleeding.The performance of the bleeding model was evaluated by 2 independent endoscopists and 12 fellows with a 4-point Likert scale.

A total of 36 gastric ulcers were created in 5 female animals (7.2±0.8)ulcers/animal.Successful active ulcer bleeding (Forrest Ib) was achieved in all ulcers. Of 36 ulcers, the average size was 2.3±0.9 cm (range, 0.7 to 3.5 cm), and the average operation time was 6.8±3.1 min (range, 2 to14 min). ESD was performed for 24 ulcers with EMR-L for 12 ulcers.Endoscopic experts assessed the realism of the ulcers and bleeding, and satisfaction of bleeding at 3.3±0.8, 3.5±0.7 and 3.8±0.5 respectively on a four-point Likert scale. The fellows′ skills and competency for endoscopic hemostatic techniques was significantly improved after training (pre vs post, 1.9±0.5 vs 3.6±0.4, P<0.05).

The live porcine model for acute upper gastrointestinal bleeding was demonstrated to be easy, feasible, realistic, reproducible and time efficient.This model will facilitate fellows′ quickly handling endoscopic hemostasis skills, and have good application value in endoscopic teaching and training.