食管静脉曲张破裂出血内镜下结扎治疗远期疗效  

Evaluation of long term effect of endoscopic ligation of bleeding esophageal varices

作　　者：黄裕新[1] 闻勤生[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内科,陕西西安710038

出　　处：《第四军医大学学报》2001年第9期858-860,共3页Journal of the Fourth Military Medical University

摘　　要：目的　作者多年采用内镜下结扎治疗食管静脉曲张(EVL ) ,研究远期疗效及并发症 .方法　住院肝硬化合并中重度食管静脉曲张破裂出血患者 10 5例 ,在出血后 72 h或无出血时择期行 EVL .结扎后分别在 4wk,6 m o,1和 2 a进行追踪及胃镜随访复查 . 4wk内结果作为近期疗效判断 ;6 m o以上结果作为远期疗效评价 .结果　静脉曲张近期根治率及总有效率分别为 80 %和 86 % . 6 mo后共随访到 75例 ,其远期根治率及总有效率分别为 5 1%和 77% ,与近期疗效比较有显著性差异 (P<0 .0 5 ) .而近期与远期再出血率及死亡率比较 ,无显著变化 (P>0 .0 5 ) .结论　 EVL近期疗效确切 ,安全可靠 .但远期疗效并非乐观 ,常需重复行 EVLAIM To make a follow up study of endoscopic esophagus varix ligation (EVL) cases in the past several years and evaluate their long term effectiveness and complications. METHODS 105 hospitalized patients of hepato cirrhosis with moderate and serious hemorrhagic varix of esophagus underwent EVL at 72 h after bleeding or at a time when no bleeding was observed. Follow up study and gastroscopy were made of the patients at 4 weeks, 6 months, 1 year and 2 years after the EVL. Results of the follow up observations at 4 weeks were classified as evaluation of short term effectiveness; and those at 6 months or later were classified as evaluation of long term effectiveness. RESULTS Short term and total cure rates of esophagus varix were 80% and 86% respectively. 75 cases were followed up at 6 months, whose long term and total cure rates were 51% and 77% respectively. There was a significant difference between the short term cure rates and long term cure rates ( P <0.05) whereas no significant difference ( P <0.05) was observed between short term and long term bleeding rates and death rates. CONCLUSION Short term cure rate of EVL is distinct, safe and reliable whereas long term cure rate is not so desirable for which another EVL or surgical operation is needed.

关 键 词：食管静脉曲张破裂出血 内镜下 结扎术 治疗 疗效 

分 类 号：R571.3[医药卫生—消化系统]