食管静脉曲张内镜结扎术后近期再出血危险因素的探讨  

RISK FACTORS OF RE-BLEEDING SHORTLY AFTER ENDOSCOPIC LIGATION OF VARIX OF ESOPHAGUS

作　　者：黄裕新[1] 闻勤生[1] 雷巧玲[1] 张少玲[1] 穆琳[1] 

机构地区：[1]第四军医大学唐都医院消化科,西安710038

出　　处：《中国内镜杂志》2000年第3期7-8,共2页China Journal of Endoscopy

摘　　要：目的 :探讨食管静脉曲张结扎术 (EVL)后早期再出血的危险因素及防范对策 ,旨在的提高EVL的成功率及效果。方法 :对 10 5例食管静脉曲张患者 ,进行了择期内镜下结扎治疗 179次 ,对其术后近期再出血患者进行了危险因素分析。结果 :并发近期再出血 15例 (14.3% ) ,分别发生于术后第 4～ 10d ,尤以术后第 7d为最高(40 .0 % )。经及时抢救治疗 ,9例出血停止 ,5例死亡 ,1例自动出院。结论 :术后 1周前后是再出血高危时期 ,饮食不当是主要诱因 ,胃食管返流是其危险因素之一 ,任何增加腹压的动作均可造成术后再出血。另外 ,亦与全身状况密切相关。Objective: To investigate the risk factors of re-bleeding shortly after endoscopic ligation of varix of esophagus and ways to prevent it. Methods: 105 cases of varix of esophagus underwent the endoscopic ligation 179 times. Cases that bled again shortly after the ligation were observed and the risk factors involved were analyzed. Results: 15 (14.3%) of the early re-bleeding cases occurred at 4-10d after the ligation. The 7th day claimed the highest rate of re-bleeding (40%). The bleeding in 9 of the 15 patients was stopped by emergency hemostatic measures. 5 died and 1 left the hospital without notifying the hospital. Conclusions: The highly risk period of re-bleeding is usually in the first week after the ligation. Inappropriate diet is the primary predisposing cause. Gastroesophageal regurgitation and any movement that increases abdominal pressure may also lead to the re-bleeding. Furthermore, it is also related to the overall health of patients. For the prevention of the re-bleeding, some advice are put forward in this paper.

关 键 词：内镜 食管静脉曲张 出血 结扎治疗 

分 类 号：R571.305[医药卫生—消化系统]