新消化道静脉曲张记录方法在内镜治疗食管胃底静脉曲张出血中的作用研究  

LDRf typing in the role of endoscopic treatment of bleeding esophageal varices

作　　者：刘变英[1] 王颖[1] 雷宇峰[1] 李小会[1] 杨嫦娥[1] 

机构地区：[1]山西煤炭中心医院消化内科,山西030006

出　　处：《中华腔镜外科杂志（电子版）》2012年第5期30-33,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的 探讨新消化道静脉曲张记录方法(LDRf分型)在内镜治疗食管胃底静脉曲张出血中的作用。方法 对104例肝硬化食管胃底静脉曲张破裂出血患者行急诊内镜下检查,采用新消化道静脉曲张记录方法,根据曲张静脉不同位置和直径选择硬化治疗术(EIS)、套扎治疗术(EVL)或者组织胶治疗术。观察术中、术后并发症的发生情况,并于1个月后复查胃镜观察食管胃底静脉情况。结果 104例中食管静脉曲张(Le)93例,食管胃静脉曲张(Le,g)36例,胃静脉曲张(Lg)3例。102例(98%)患者急诊止血成功,1例(2%)止血失败,表现为术后6d内反复便血,行经颈静脉肝内门腔静脉内支架分流术治疗后出血停止。术后1个月复查胃镜,见42例(45.16%)食管静脉曲张消失,56例(60.22%)中上段食管静脉基本消失。28例(71.2%)胃底静脉曲张消失,33例(84.61%)患者可观察到多种形态的排胶形式,如球状、点状等,颜色为黑色、黄白色以及褐色等。术后常见的并发症有咽下不适、胸骨后痛、低至中度发热,发生率为15.9%,未发生严重并发症。结论 采用新消化道静脉曲张记录方法在内镜治疗食管胃底静脉曲张出血中,对治疗方法的选择具有指导意义,有助于提高内镜下治疗成功率,减少并发症发生。Objective Exploring LDRf typing in the endoscopic treatment of bleeding escophagealvarices.Methods To adopt LDRf typing methods,104 patients with cirrhosis and esophageal varicesbleeding underwent emergency endoscopy,according to the different location and diameter of varicose veinsselect endoscopic injiction sclerotherape (EIS),endoscoic variceal ligation (EVL) or tissue gluetreatment.Intraoperative,postoperative complications, and observed the disappearance of esophageal andgastric vein aftor January endoscopy. Results One hundred and four cases of esophageal varices (Le)93, esophagogastric varices(Le,g) 36 cases of gastric varices(Lg).One hundred and two cases (98 %)patients with emergency hemostasis,1 (2 %) hemostasis failed, performance for 6 days after repeatedblood in the stool,bleeding stopped after the line TIPSS treatment. After January endoscopy to see 42cases ( 45.16%) of esophageal varices disappeared in 56 cases (60.22%),upper esophageat veinsdisappeared.Twenty-eight cases (71.2 %) of the gastric fundus varices disappeared.Thirty-three cases(84.61%) were observed in a variety of forms of latex form,such as spherical,punctate,color isblack,white,yellow, brown etc.Postoperative complications common swallow discomfort, chest pain,lowto moderate fever,the incidence rate of 15.9 % ,and no serious complications.Conclusions LDRf typingmethods help to improve the success rate of endoscopic therapy,and reduce complications,it has a guidingsignificance in the endoscopic treatment of choice of treatment of bleeding esophageal varices.

关 键 词：食管胃静脉曲张 止血 内窥镜 LDRf分型 

分 类 号：R575.2[医药卫生—消化系统]