急诊胃镜下结扎治疗食管静脉曲张破裂活动性出血  

Emergency endoscopic variceal ligation for the treatment of esophageal variceal active bleeding

作　　者：石定[1] 张秋凤[1] 尤华强[1] 

机构地区：[1]杭州师范学院医学院附属余杭医院消化科,311100

出　　处：《中国急救医学》2008年第9期793-795,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的总结内镜下急诊结扎治疗食管静脉曲张破裂活动性出血的经验。方法对明确出血位置在食管的47例活动性出血患者和不能明确具体出血位置的10例活动性出血可疑食管静脉曲张破裂患者,均于入院后第一时间内施行紧急内镜下食管静脉曲张结扎治疗,监测结扎前、术中及结束时血压、呼吸、心率变化。结果内镜下明确食管静脉曲张破裂喷射状出血47例,止血成功率100%。因视野模糊不能明确出血部位10例,止血成功率80%,死亡2例。结论急诊内镜下结扎对能明确具体出血部位的食管静脉曲张破裂活动性出血是安全有效的止血方法,宜在出血早期进行;对不能明确具体出血部位但有活动性出血的可疑食管静脉曲张破裂患者应慎重。Objective To evaluate the efficacy of emergency endoscopic varice ligation （ EEVL ） in the treatment of cirrhosis esophageal variceal active bleeding. Methods 47 patients with cirrhosis esophageal variceal active bleeding whose exact bleeding site were identified and 10 patients with doubtful esophageal variceal bleeding whose exact bleeding site were not identified accepted EEVL immediately on admission and the monitoring of heart rate, blood pressure, and respiratory rate before, during and after EEVL was conducted. Results Spurting bleeding could be visualized in 47 patients and emergency effective rate of EEVL was 100%. The exact bleeding site could not be visualized in 10 patients and the effective rate of EEVL was 80%. Two patients died. Conclusion EEVL is safe, effective measure in treating esophageal variceal spurting bleeding. EEVL should be carefully utilized in the patients with doubtful esophageal variceal bleeding whose exact bleeding site were not identified.

关 键 词：食管静脉曲张出血 急诊胃镜 结扎 

分 类 号：R571.3[医药卫生—消化系统]