肝硬化食管胃底静脉曲张合并腹外疝行 内镜下治疗疗效及的的体会.docVIP

肝硬化食管胃底静脉曲张合并腹外疝行 内镜下治疗疗效及的的体会 　　 　　 　　（1.山东省沂源县人民医院普外科，沂源266000；2.山东省淄博市中心医院妇产科，淄博225000；3.江苏省徐州市中心医院普外科，徐州221009） 　　[摘要]目的：汇总分析肝硬化合并食管胃底静脉曲张(Esophagogastric varices，EGV)和腹外疝的临床治疗情况，探讨内镜下治疗该类疾病的临床疗效和安全性。方法：以我院2008年3月至2013年4月间收治的17例肝硬化合并EVG和腹外疝的患者为研究对象，对其行内镜下治疗的临床疗效、安全性等进行汇总分析。结果：17例EGV患者中，行静脉套扎5例，静脉硬化治疗2例，静脉注射组织胶治疗4例，组织胶联合静脉套扎治疗6例。2周内17例患者中共计发生再出血事件2例，发生嵌顿疝3例次，经再次内镜下治疗和手法还纳处理后，静脉出血和嵌顿疝症状均消除。在并发症方面，以胸骨后疼痛、剑突下疼痛等为主要症状，可耐受，术后短期内即自行消除。1年随访结果显示，3例患者死亡，14例存活，死亡原因多由肝功能衰竭所致，未见其他后遗症。结论：内镜下治疗肝硬化患者食管胃底静脉曲张合并腹外疝，临床疗效明确、安全可靠，配合适当术中处理措施可降低嵌顿疝发生率。 　　[关键词]肝硬化；食管为敌静脉曲张；腹外疝；内镜治疗 　　中图分类号：R573文献标识码：B文章编号：2095-5200（2014）04-040-04 　　DOI：10.11876/mimt201404013 　　A clinical analysis about the efficacy of endoscopic treatment for the cirrhosis with esophagogastric varices and herniaSHAO Le-zhai1，ZHANG Yong2，KOU Chang-hua3.（1.The general surgery of people’s hospital of Yiyuan county, Shandong Province,Yiyuan 2660002,China; 2.The central hospital of Zibo city in Shandong province, Zibo 255000, China；3.The general surgery of the central hospital of Xuzhou city in Jiangsu province, Xuzhou 221009, China） 　　[Abstract]Objective：To make a meta-analysis about the clinical treatment of the cirrhosis patients with esophagogastric varices and hernia, investigate the efficacy and safety of endoscopic treatment. Methods：17 cases patients with cirrhosis patients with esophagogastric varices and hernia were the objects of this study, which had been treated in our hospital with endoscopy during 2008.03-2013.04, gather and compared the clinical effect and safety of endoscopic hemostasis. Results：Among 17 cases patients, 5cases received a treatment with vein ligation, 2 cases patients were treated by venous sclerosis, 4 cases treated by tissue glue injection, and 6 cases treated by vein ligation joint with tissue glue injection. Within postoperative 2 weeks, 2 cases occurred re-bleeding, 3 cases occurred incarcerated hernia, the symptoms were eliminate by again endoscopic therapy and techniques als