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胃镜下组织胶注射联合套扎术在食管胃静脉曲张出血治疗中的应用价值

Treament of gastroesophageal varices bleeding with endoscopic tissue adhesive injection combined with endoscopic variceal ligation

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【作者】 杨文斌刘未雄刘文许剑刘雄祥田赞

【Author】 YANG Wen-bin,LIU Wei-xiong,LIU Wen,XU Jian,LIU Xiong-xiang,TIAN Zan(Department of Gastroenterology,Xiangtan Central Hospital,Xiangtan 411100,China)

【机构】 湘潭市中心医院消化内科

【摘要】 目的:探讨胃镜下组织胶注射联合套扎术治疗食管胃静脉曲张出血的临床价值。方法:采用胃镜下组织胶注射联合套扎术治疗45例肝硬化并发食管胃静脉曲张破裂出血患者,并随访3个月,观察急诊止血成功率、再出血率、食管胃静脉曲张改善情况以及并发症发生情况。结果:45例患者急诊止血成功率100%。随访3个月期间,失访1例,1例再出血死亡,2例出现排胶出血,再出血率6.81%;食管静脉曲张治疗总有效率95.2%,胃静脉曲张治疗总有效率90.5%;术后胸骨后疼痛30例(66.6%),低热5例(11.1%),上腹不适、上腹痛10例(22.2%),胃溃疡2例(4.4%)。所有病例未见异位栓塞、败血症、食管狭窄、穿孔等严重并发症。结论:胃镜下组织胶注射联合套扎术治疗食管胃静脉曲张是一种安全可靠的方法,并且疗效良好,值得临床推广应用。

【Abstract】 Objective: To investigate the efficacy of endoscopic tissue adhesive injection combined with endoscopic variceal ligation in the treatment of gastroesophageal varices bleeding.Methods: Forty-five patients with gastroesophageal variceal bleeding received endoscopic tissue adhesive injection combined with EVL in the treatment of patients.The patients received follow-up endoscopy in 1 and 3 months after the procedure,respectively.The variants including the rate of acute hemostasis,the rate of rebleeding,the rate of complication,and degree of esophagogastric varices were evaluated.Results: The rate of acute hemostasis was 100%.One patient was lost in follow-up period of 3 months.The rate of rebleeding was 6.81%.The total effective rate of esophageal varices was 95.2%.The total effective rate of gastric varices was 90.5%;Seven patients underwent second ligation.Chest pain in 30 patients(66.6%),fever in 5 patients(11.1%),abdominal pain in 10 patients(22.2%),gastric ulcer in 2 patients(4.4%).No severe procedure-related complication was observed in all patients.Conclusion: Endoscopic tissue adhesive injection combined with EVL is a safe and effective therapy for gastroesophageal varices bleeding.

  • 【文献出处】 现代医学 ,Modern Medical Journal , 编辑部邮箱 ,2013年07期
  • 【分类号】R575.2
  • 【被引频次】8
  • 【下载频次】96
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