内镜下亚甲蓝联合硬化剂注射治疗直肠异位静脉曲张出血  

Endoscopic injection of methylene blue combined with curing agent in the treatment of ectopic rectal varicose hemorrhage

作　　者：王玲玲 葛青 黄勤 叶丽萍 WANG Lingling;GE Qing;HUANG Qin;YE Liping(Department of Gastroenterology,Taizhou Hospital Affiliated to Wenzhou Medical University,Enze Hospital Taizhou Enze Medical Center(Group),Taizhou 318000,China)

机构地区：[1]温州医科大学附属台州医院台州恩泽医疗中心(集团)恩泽医院消化内科,浙江台州318000

出　　处：《温州医科大学学报》2021年第11期924-927,930,共5页Journal of Wenzhou Medical University

摘　　要：目的:探讨内镜下亚甲蓝联合硬化剂注射治疗直肠异位静脉曲张出血的内镜下治疗方法及效果。方法:回顾性分析2例直肠异位静脉曲张出血的诊断,内镜下注射亚甲蓝联合硬化剂的手术过程、手术注意事项及治疗效果。结果:直肠异位静脉曲张的诊断主要依靠腹部CT、选择性血管造影、电子肠镜等。亚甲蓝联合硬化剂可确保注射针精准注射、治疗视野更清楚、协助判断硬化剂使用剂量,减少内镜治疗相关并发症。采用内镜下注射亚甲蓝联合硬化剂的治疗方法,成功地治疗2例直肠异位静脉曲张出血患者。结论:直肠异位静脉曲张出血较为罕见,出血量大,病情危重,首选内镜下治疗。内镜下亚甲蓝联合硬化剂注射治疗直肠异位静脉曲张出血是安全和有效的。Objective:To seek a new endoscopic treatment for ectopic rectal varicose hemorrhage with methylene blue combined with curing agent.Methods:A retrospective analysis was performed on two cases of ectopic rectal varicose hemorrhage,focusing on the diagnosis,procedures of endoscopic injection of methylene blue combined with curing agent,the surgical precautions and the therapeutic effect.Results:The diagnosis of ectopic rectal varices mainly depends on abdominal CT,selective angiography and electronic colonoscopy.Methylene blue combined with curing agent could ensure the precise injection,a much clearer operation field,the co-assessment of the dosage of the curing agent,thus reducing the endoscopic complications.Methylene blue injection combined with curing agent under endoscope was used to successfully treat 2 patients with ectopic rectal varicose hemorrhage.Conclusion:Endoscopic treatment is usually the first choice for ectopic rectal varicose hemorrhage,which is rare and complicated with large amount of bleeding and critical condition.Methylene blue injection combined with curing agent under endoscope is safe and effective in the treatment of ectopic rectal varicose hemorrhage.

关 键 词：异位静脉曲张出血 直肠 内镜 亚甲蓝 硬化剂 

分 类 号：R575[医药卫生—消化系统]