透明帽辅助内镜下硬化治疗在食管静脉曲张破裂出血中的应用价值  

The application value of transparent cap assisted endoscopic sclerotherapy in esophageal varices bleeding

作　　者：周刚[1] 王志勇[1] 吴建良[1] 孙丽伟[1] 郭赟[1] 付金龙[1] 马菊妹[1] 胡姣娣[1] 张圣娇 

机构地区：[1]杭州师范大学附属医院消化内科,浙江杭州310015

出　　处：《中国内镜杂志》2015年第2期136-140,共5页China Journal of Endoscopy

摘　　要：目的探讨透明帽辅助内镜下硬化治疗肝硬化食道静脉曲张破裂出血中的应用价值。方法 2009年6月-2012年3月该院对77例肝硬化食道静脉曲张破裂出血患者随机分组,分别采用透明帽辅助内镜下硬化治疗(CFG)和常规内镜下硬化治疗(NCF),CFG组硬化剂注射后针孔用内镜先端透明帽进行压迫,NCF组硬化剂注射后针孔用内镜镜身进行压迫。比较分析两组硬化剂治疗后压迫效果,6周后食管溃疡发生率、出血发生率和静脉曲张消失率。结果 CFG组压迫后再出血的发生率较NCG组明显减少;虽然6周后两组食管溃疡发生率差异无显著性,但CFG组食管深溃疡的发生率明显减少,6周后再出血的发生率也较NCF组较少;静脉曲张消失率差异无显著性。结论透明帽辅助内镜下硬化治疗食道静脉曲张破裂出血,保持视野清晰,起到固定靶静脉,注射后压迫方便,明显减少压迫后再出血率,较少术后深溃疡形成,再出血的发生率,该方法值得临床借鉴。【Objective】To investigate the application value of the transparent cap assisted endoscopic sclerotherapy of esophageal varices bleeding 【Methods】 In 77 cases of esophageal varices bleeding patients in Hangzhou Normal University Affiliated Hospital during June 2009 to March 2012 received randomly transparent cap assisted endoscopic sclerotherapy（CFG） and conventional assisted endoscopic sclerotherapy（NCF）. For CFG group after injection of sclerosing agent was pressed by endoscopic transparent cap. For NCF group after injection of sclerosing agent, the mirror body was pressed by endoscopy. The hardening effects of oppression after sclerotherapy,esophageal ulcer incidence rate and incidence of blood and varicose vein disappearance rate after 6 weeks were compared between two groups.【Results】After the oppression, the recurrent hemorrhage rate of CFG group decreased obviously compared with NCG group, while after 6 weeks, esophageal ulcer incidence rate had no significant difference between two groups. But for group CFG, esophagus deep ulcers occurred significantly less than NFG group and less incidence of rebleeding after 6 weeks; varicose vein disappearance rate was no significant difference.【Conclusion】Transparent cap assisted endoscopic sclerotherapy for esophageal varices bleeding can maintain clear vision to fix the target vein and have a convenient injection pressure. Rebleeding rate decreased significantly after pressure with less postoperative deep ulcer formation.

关 键 词：肝硬化 食道静脉曲张破裂出血 硬化治疗 内镜透明帽 

分 类 号：R443.8[医药卫生—诊断学]