经鼻内镜下行改良三腔二囊管合并硬化剂治疗食道静脉曲张破裂出血的临床疗效.docVIP

经鼻内镜下行改良三腔二囊管合并硬化剂治疗食道静脉曲张破裂出血的临床疗效 （附14例临床分析） 杜志强1，郑玉梅2 （1 四川省简阳市人民医院消化内科，四川简阳 641400；2 四川省资阳市第一人民医院普外科，四川资阳 641300） 摘要：目的：观察经鼻内镜检查引导下通过改良三腔二囊管加沙氏导丝引导支撑，结合内镜下硬化剂治疗肝硬化食管静脉曲张破裂出血的疗效。方法： 14例肝硬化食道静脉曲张破裂出血患者经过经鼻内镜检查后通过改良的三腔二囊管加沙氏导丝支撑下，结合内镜下硬化剂治疗食管静脉曲张破裂出血，观察止血效果以及并发症。结果：14例患者均1次止血成功，1例患者治疗后8h再次出血，行急诊TIPSS手术治疗。主要反应为胸骨后疼痛，持续时间为2-7d，对症处理后消失，3、6个月后再次复查食道胃底静脉明显改善，3例10d左右行内镜下再次硬化治疗（因第1次硬化剂量少或治疗不完全）。结论：经鼻内镜检查行改良三腔二囊管加沙氏导丝引导支撑下，结合内镜下硬化剂治疗肝硬化食管静脉曲张破裂出血是一种有效的治疗方法。 关键词：经鼻胃镜；食道胃底静脉曲张；改良三腔二囊管；硬化剂 [中图分类号] R573；R571*.3 [文献标志码] A [文章编号] 1002-0179（2009）09-2421-03 Endoscopic Modified by the Three Cavity Tube 2 Capsule Combined Sclerotherapy of Esop- -hageal Varices Bleeding Clinical Efficacy (Clinical Analysis of 14 Cases) DU Zhiqiang , ZHENG Yumei. （The People s Hospital of Jian yang City , Jian yang Si chuan 641400, China） Abstract: Objective: To investigate the nasal endoscopy guided through an improved three cavit -y tube 2 capsule guide wire Gazas support, combined with endoscopic sclerotherapy of esophag- -eal variceal bleeding in cirrhotic patients. Methods: 14 cases of liver cirrhosis patients with esop- -hageal variceal bleeding after nasal endoscopy after the adoption o f an improved three cavity tu- -be 2 capsule support Gazas guide wire, the combination of endoscopic sclerotherapy of esophag- -eal variceal bleeding，hemostatic effect observed and complications. Results: The results of 14 cases of bleeding in patients with 1 are successful, one cases o f patients with bleeding again after 8h, the TIPSS emergency surgery. The main reaction fo r substernal pain, duration o f 2 ~ 7 d, symptoms disappeared after treatment, 3, 6 months after the re-review of esophageal gastric var- -ices improved 10 d about three cases o f endoscopic sclerotherapy again ( because of paragraph 1 hardening treatment dose of less than or incomplete) . Conclusion: The modified nasal endoscopy capsule pipe three cavity second guide wire to guide the Gaza St rips support, the combination of endoscopi