内镜下静脉结扎术治疗食道静脉曲张出血及其对门静脉系血流动力学影响  

THE EFFECTS OF ENDOSCOPIC LIGATION ON PORTAL HEMODYNAMICS

作　　者：李克军[1] 王忠裕[1] 殷朔[1] 赵荣宇[1] 金银云[1] 戴小南 晋佩禹[1] 宫爱霞[1] 

机构地区：[1]大连医科大学第一临床学院外科

出　　处：《中国内镜杂志》1998年第4期8-9,11,共3页China Journal of Endoscopy

摘　　要：该文报告应用内镜下静脉结扎术治疗门静脉高压症所致食道静脉曲张出血４１例。其中２２例活动性出血者结扎后２１例出血停止，即刻止血率９５．４５％，３３例食道静脉曲张完全清除或减轻至Ⅱ度以下，有效率８０．４９％。２５例在结扎治疗前后用彩色多普勒监测门静脉系统血流变化。门静脉血流量、脾静脉血流量、肠系膜上静脉血流量的术前术后变化无显著性差异（Ｐ＞０．０５）。此方法能阻断胃左静脉－奇静脉－腔静脉这条出血性侧枝，从而控制或预防食道静脉曲张出血。对门静脉系统血流量无明显影响，对肝功能无损害。该法疗效肯定、安全，操作简单，适应证广泛，是对肝功能不良不能耐受手术者或开腹手术后复发出血者的最佳治疗方法之一。该方法不能减低门静脉阻力也不能改善门静脉高血流状态，故有与时间延长相伴增长的较高复发率。Endoscopic variceal ligation (EVL) was used to treat 41 patients with esophageal variceal hemorrhages. After the procedure, immediate hemostasis was obtained in 95.45% of the patients(21/22) with active variceal bleeding. Varices were eradicated or reduced to grade one in 80.49% of the patients (33/41) after two to six consecutive procedures. The hemodynamics of the portal venous system was studied by Duplex ultrasonography before and after EVL in 25 of the 41 patients. It was found that after EVL, the changes observed in the portal blood flow were not significantly different (P>0.05).

关 键 词：内镜 静脉结扎术 门静脉高压 食道静脉曲张 出血 

分 类 号：R657.340.6[医药卫生—外科学] R655.405[医药卫生—临床医学]