内镜下组织胶注射联合套扎术治疗食道胃底静脉曲张出血的疗效观察  

Observation of the efficacy of endoscopic histoacryl injection combined with variceal ligation in the treatment of gastroesphageal variceal bleeding

作　　者：邹永军[1] 曹杰[1] 杜雪梅[1] 张晓云[1] 王波[1] 张丽荣[1] 

机构地区：[1]吉林省肝胆病医院消化内镜科,长春130062

出　　处：《中国临床新医学》2011年第2期124-127,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨食道静脉曲张套扎术联合胃底静脉曲张组织治疗术治疗肝硬化食道胃底静脉曲张急性出血的的临床意义。方法 56例确诊肝硬化门脉高压食道或胃底静脉曲张急性出血的患者,于出血24 h内行食道静脉曲张套扎术联合胃底静脉曲张组织胶注射治疗,术后1、3、6个月行内镜随访,观察再出血率、食道胃底静脉曲张好转情况。结果 56例病人全部止血成功,1个月内再发出血5例,3例为排胶期轻度渗血,2例出血量较大,5例病人重新进镜行内镜下喷洒正肾液后血止;6个月内复查无再出血发生。食道静脉曲张治疗有效率为96%,胃底静脉曲张治疗有效率为95%。结论肝硬化食道胃底静脉曲张急性出血应用内镜组织胶注射联合曲张静脉套扎术是一种安全、疗效肯定的的治疗方法。Objective To discuss the clinical significance of esophagus varieeal ligation combined with gastrie fundal variees tissue iatrotechnics in treatment of acute gastroesophageal varieeal bleeding caused by hepatoerrhosis. Methods Fifty-six patients, with diagnosed acute gastroesophageal varieeal bleeding caused by hepatoeirrhosis and portal hypertension, were treated with esophagus varieeal ligation combined with gastric fundal variees tissue iatroteehnics within 24 hours after bleeding, and were followed up by endoscopy at 1 month ,3 months, 6 months after operation,and the re-bleeding rate and the conditions of gastroesophageal variees were observed. Results All the patients obtained successful hematischesis. Five cases showed re-bleeding within 1 month, including 3 patients with light bleeding during discharging tissue glue, and 2 patients with more bleeding. The 5 patients obtained newly hematischesis by endoscopic insuftlation norepinephrine, and no bleeding recurred in 5 patients within 6 months. The effective rate of treatment for esophageal varices was 96%, and that for gastric fundus varices was 95%. Conclusion The endoscopic histoacryl injection combined with variceal ligation in the treatment of acute gastro esophageal variceal bleeding caused by hepatocirrhosis is a therapeutic method of safe and definite curative effect.

关 键 词：肝硬化 食道胃底静脉曲张出血 组织胶注射 曲张静脉套扎术 内镜治疗 

分 类 号：R605.972[医药卫生—急诊医学]