肝硬化食管胃底静脉曲张内镜下治疗的临床观察  

The clinical observation of the treatment of liver cirrhosis with esophageal and gastric varices under endoscopy

作　　者：黄艳芳[1] 陈永忠[1] 

机构地区：[1]郑州大学第一附属医院消化内一科,河南郑州450052

出　　处：《胃肠病学和肝病学杂志》2016年第5期529-531,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：河南科技厅基础(112300410029)

摘　　要：目地探讨内镜下套扎序贯硬化剂治疗(endoscopic sequential variceal ligation plus sclerotherapy,EVLS)及胃底组织胶注射术治疗食管胃底静脉曲张的疗效和安全性。方法观察61例肝硬化食管胃底静脉曲张出血患者行EVLS及胃底组织胶注射术后食管胃底静脉曲张变化情况,分析其有效性、安全性及并发症。结果经EVLS后,食管静脉曲张完全消失率、基本消失率、改善率分别为27.9%、47.5%及24.6%。胃底经组织胶注射后显效79.3%,有效20.7%。3.4%发生排胶出血。内镜下食管静脉曲张套扎术(EVL)后并发出血率0.9%,内镜下食管静脉硬化注射术(EIS)后并发出血率1.9%。EIS术后食管狭窄发生率3.3%,术后早期进食哽噎感、胸骨后疼痛、恶心、呕吐等轻微不良反应发生率高,短期内均可消除。结论 EVLS治疗效果显著、安全性高、并发症少、复发率低、依从性较好,胃底静脉曲张行组织胶注射术疗效及安全性好。Objective To explore the therapeutic effects and safety of endoscopic sequential variceal ligation plus sclerotherapy （EVLS） and gastric tissue glue injections in treatment of esophageal and gastric varices. Methods Sixtyone eases of liver cirrhosis with esophageal gastric varices bleeding were treated with EVLS and gastric tissue glue injections, the effect, safety and complications were observed. Results After EVLS, the rates of complete obiteration, basic obiteration and improvement of esophageal variees were 27.9% , 47.5% and 24.6%. After tissue glue injections, gas- tric varices narrowed significantly and effctively were 79.3% , 20.7%. 3.4% occurred bleeding following gatric fnndal evacuations. After endoscopic variceal ligation （EVL） , the hemorrhage rate was 0.9% , while the concurrent hemorrhage rate was I. 9% after endoscopic injection sclerotherapy （EIS） , the rate of esophageal stenoses was 3.3%. Early mild adverse reactions were high such as the feeding of choking when swallowing, retrosternal pains, nausea, vomiting and so on, but could he eliminated shortly. Conclusions The effect of the EVLS is remarkable, the higher safety, the less complications, the lower recurrence rates and the better applications. The tissue glue injections of gastric venous is effective and safe.

关 键 词：食管胃底静脉曲张 内镜下套扎序贯硬化剂治疗 内镜下食管静脉曲张套扎术 内镜下食管静脉硬化注射术 

分 类 号：R575.2[医药卫生—消化系统]