粘合剂联合硬化剂治疗瘤状孤立性1型胃静脉曲张  

The study on the treatment of α-cyanoacrylate alkyl combined with aethoxysklerol for type 1 tumorous isolated gastric varices

作　　者：史琲[1] 吴云林[1] 吕婵[1] 朱晖[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科,200025 [2]上海交通大学医学院附属瑞金医院放射科,200025

出　　处：《肝脏》2008年第4期287-291,共5页Chinese Hepatology

摘　　要：目的评价粘合剂α-氰基丙烯酸烷基酯联合硬化剂乙氧硬化醇治疗瘤状孤立性1型胃静脉曲张(IGV1)出血的临床疗效。方法对16例瘤状IGV1出血患者进行内镜下α-氰基丙烯酸烷基酯联用乙氧硬化醇注射治疗,观察临床止血疗效、胃静脉曲张消除情况及临床不良反应。结果全组16例患者粘合剂和硬化剂平均注射次数为(1.56±0.51)次,α-氰基丙烯酸烷基酯每例平均注射(1.36±0.20)ml,乙氧硬化醇每例平均注射(7.13±2.96)ml,即时止血率100%。术后平均随访(244.44±90.51)d内,再出血率18.75%,无死亡病例。内镜随访胃静脉曲张消退显著有效6例(42.86%),有效6例(42.86%),无效2例(14.28%),总有效率为85.72%。结论内镜下粘合剂α-氰基丙烯酸烷基酯联合乙氧硬化醇治疗控制瘤状IGV1出血迅速有效,并有望消除胃静脉曲张。Objective To evaluate the clinical effect of the tissue adhesive a-cyanoacrylate alkyl combined with sclerosant 1% aethoxysklerol on the treatment of type 1 tumorous isolated gastric varices （IGV1）. Methods 16 patients with IGV1 underwent endoscopic sclerotherapy with combined 1% aethoxysklerol and α-cyanoacrylate alkyl. Then the hemostatic effects, eradication of gastric varices and the clinical adverse reactions were observed colsely. Results The average time of injection was 1.56 ±0.51. The average total volume of α-cyanoacrylate alkyl was （1.36 ± 0.20） ml. The average 1oral volume of aethoxysklerol was （7. 13 ± 2.96） ml. Initial hemostasis was achieved in all patients （100%）. During the follow-up period of （244.44 ± 90.51 ） days, rebleeding rate was 18.75% and no mortality was observed. The varices were disappeared in 6 patients （42. 86%）, flattened in 6 patients （42. 86%） and reduced insignificantly in 2 patients （ 14. 28 % ）. The total effective rate was 85.72%. Conclusion This method carried out using the tissue adhesive α-cyanoacrylate alkyl combined with the injection of 1% aethoxysklerol might be an alternative and feasible method for hemostasis and eradication of tumorous IGV1.

关 键 词：胃静脉曲张 α-氰基丙烯酸烷基酯 乙氧硬化醇 内镜治疗 

分 类 号：R575.2[医药卫生—消化系统]