经内镜注射氰基丙烯酸酯治疗儿童急性食管-胃底静脉曲张破裂出血的效果观察  

Effect of endoscopic injection of cyanoacrylate in treatment of acute esophageal and gastric variceal bleeding in children

作　　者：张孝兴[1] 李倩[2] 杨凯龙[2] 韩鹏[2] 张迎旭[2] 

机构地区：[1]宝鸡市妇幼保健院儿童医院儿童重症科,陕西宝鸡721000 [2]宝鸡市妇幼保健院,陕西宝鸡721000

出　　处：《临床肝胆病杂志》2016年第5期925-927,共3页Journal of Clinical Hepatology

摘　　要：目的探讨经内镜注射氰基丙烯酸酯治疗儿童急性食管-胃底静脉曲张破裂出血的效果和安全性。方法回顾性分析2010年8月-2015年8月在宝鸡市妇幼保健院儿童医院采用经内镜注射氰基丙烯酸酯进行治疗的35例急性食管-胃底静脉曲张破裂出血患儿的临床资料。统计分析治疗后的急诊有效率、再次出血率以及并发症的发生情况。结果 35例患者共经46次内镜注射氰基丙烯酸酯治疗,治疗有效率为95.6%（44/46）,每次注射氰基丙烯酸酯的量为0.2-0.6 ml,平均（0.4±0.2）ml。急诊止血率为93.4%（43/46）;再次出血4例,占11.4%（4/35）,4例复发出血的患者治愈周期为1.2-23.0个月,平均（12.1±10.9）个月。1例患者出现腹痛,无患者并发异位栓塞。2例患者术后死亡。结论经内镜少量多次注射氰基丙烯酸酯治疗儿童急性食管-胃底静脉曲张破裂出血疗效确切,操作方便,并发症少,值得推广。Objective To investigate the effect and safety of endoscopic injection of cyanoacrylate in the treatment of esophageal and gastric variceal bleeding（ EGVB） in children. Methods The clinical data of 35 children with acute EGVB who were treated with endoscopic injection of cyanoacrylate in Children＇s Hospital of Baoji Maternal and Child Health Care Hospital from August 2010 to August 2015 were analyzed retrospectively. The emergency response rate,rebleeding rate,and incidence of complications after the treatment were analyzed statistically. Results Thirty- five patients received 46 times of endoscopic injection of cyanoacrylate in total. The response rate to the initial injection was 95. 6%（ 44 /46）. The volume of cyanoacrylate injected was 0. 2- 0. 6 ml,with a mean volume of 0. 4 ± 0. 2 ml. The emergency hemostasis rate was 93. 4%（ 43 /46）,the rebleeding rate was 11. 4%（ 4 /35）,and the cycle for 4 patients with the recurrence of bleeding to be cured was 1. 2- 23. 0 months（ mean 12. 1 ± 10. 9 months）. One patient experienced abdominal pain,and no patients experienced ectopic embolism. Two patients died after injection. Conclusion Frequent,small- volume endoscopic injection of cyanoacrylate is an effective and convenient therapeutic method for EGVB in children,has few complications,and holds promise for clinical application.

关 键 词：食管和胃静脉曲张 内窥镜检查 消化系统 氰基丙烯酸酯 儿童 

分 类 号：R725.7[医药卫生—儿科]