经内窥镜注射硬化剂治疗晚期血吸虫病上消化道出血的临床观察  

PREVENTION OF BLEEDING DUE TO ESOPHAGEAL VARICES IN ADVANCED SCHISTOSOMIASIS JAPONICA BY ENDOSCOPIC INTRAVASCULAR SCLEROTHERAPY

作　　者：陆启新 蒋吕品[2] 刘贻典 顾奎章 杨彩伟 王德威 诸和生 吴圣薇 朱少棠 徐世杰 

机构地区：[1]苏州市血防领导小组办公室 [2]上海瑞金医院外科 [3]吴江县卫生防疫站 [4]昆山县血吸虫病防治站 [5]昆山县血防领导小组办公室 [6]吴县血防领导小组办公室

出　　处：《中国血吸虫病防治杂志》1989年第4期16-20,共5页Chinese Journal of Schistosomiasis Control

摘　　要：对33例有出血史的晚期血吸虫病人,在非出血期,经纤维胃镜注射硬化剂5％鱼肝油酸钠防止再出血,3至4年后随访,存活25例,存活率75.9％,未再发生出血的14例,占受治病人的42.4％。胃镜复查发现极大部分病人的曲张静脉条数减少,色泽转为兰色或白色,曲张程度减轻。认为食道曲张静脉注射硬化剂对防止晚血病人上消化道出血,延长寿命有一定的效果,但这种方法对曲张静脉只能起到局部保护作用并不能降低门脉压力,因此建议最好同时服用心得安等降低门脉压力的药物並应连续注射直至食道内曲张静脉全部消失为止。33 cases of advanced schistosomiasis japonica with history of bleeding due to esophageal varices were treated by injection of 5 % sodium morruhate as sclerotic substance thru G.I. fibroscope. 3-4 years after treatment, 25 cases were still alive and 14 cases had no recurrence of bleeding. Endoscopic reexamination showed a decrease in the number of esophageal varices in most cases and color turned to blue or white. It indicated that injection of sclerotic substance into esophageal varices had definite effect on prolonging life and prevention of esophageal varices bleeding in advanced schistosomiasis. But this method had only protective effect on the varices locally and could not reduce portal pressure. Therefore, the authors suggest to use drugs such as propranolol to reduce portal pressure at the same time and to inject sclerotic substance repeatedly until all the varicose veins disappear.

关 键 词：晚期血吸虫病 上消化道出血 硬化剂治疗 曲张静脉 曲张程度 心得安 胃镜复查 食道静脉 出血史 血吸虫病肝硬化 

分 类 号：R532.21[医药卫生—内科学]