内镜下静脉套扎与.docVIP

内镜下静脉套扎和组织胶注射治疗食管胃底静脉曲张破裂出血76例疗效分析 【摘要】 目的 探讨内镜下静脉套扎和胃底注射组织胶治疗食管胃底静脉曲张的疗效。方法 随机选择76名住院患者，其中男性49 例，女性28例，平均年龄 48.2岁。均为肝硬化门脉高压食管胃底静脉曲张，有近期破裂出血史。常规行胃镜检查，观察食管静脉曲张的大小、数目和位置，及胃底静脉曲张情况。内镜下选好胃底靶静脉，“三明治”法注射，根据曲张静脉直径每点注入组织胶1～2　ml，可多点注射。自胃食管黏膜连接处开始螺旋式结扎曲张静脉，相邻结扎点距离约2cm左右，至曲张静脉口侧回缩变白为止。结果 治疗后8周复查胃镜，食管静脉曲张总有效率为 88.6%，胃底静脉曲张总有效率75.1%，无异位栓塞发生，2例出现近期再出血，再次注射组织胶后血止，其余患者均无再出血。结论 内镜下套扎联合组织胶注射治疗食管静脉曲张破裂出血疗效显著，并发症少，具有临床实用性。 Analysis on Endoscopic Variceal Ligation Combining with the Injection of Histoacryl on 76 Ruptured Hemorrhage of Gastric Fundus Varices and Esophagus Varices Wu Zuoyan1 Ji Ming2 Beijing 6th Hospital1 Beijing Frendship Hospital2 [Abstract] Objective: To observe the clinical effect of endoscopic variceal ligation combining with the injection of histoacryl on ruptured hemorrhage of gastric fundus varices and esophagus varices. Method Random selected 76 patients，male 49, female 28, average age 48.2. They were all suffered from fundus varices and esophagus varices caused by portal hypertension, and all suffered ruptured hemorrhage not before long. Endoscopic examination on routine, observed the condition of esophagus varices and gstric fundus varices. Selecteded and injected target gastric fundus varices with “sandwich” method, Ligated the esophagus varices helicaly from esophagus-gastric junction, the distance between tow ligation was 2 cm. Results Re-examined endoscope 8 weeks after treatment, the total effective rate of esophagus varices was 88.6%, the total effective rate of gastic fundus varices was 75.1%, no ectopia embolism occurred, 2 patients suffered from rehaemorrhagia, and stopping bleeding after injection histoacryl again, the rest patients had no re-bleeding. Conclusion The method of endoscopic variceal ligation combining with the injection of histoacryl has great effect on gastric fundus varices and esophagus varices, which has clinical practicability. [Key words] endoscopic variceal ligation, histoacryl, varices, hemorrhage 食管胃底静脉曲张出血是消化内科常见的急危重症,占上消化道