內镜下静脉套扎和组织胶注射治疗食管胃底静脉曲张.doc

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 吴作艳1 冀明2 北京市第六医院1 100007 北京友谊医院2 100050 ? 吴作艳 北京市第六医院消化科 100007???联系电话邮箱 wuzuoyan118@ 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,占上消化道出血原因的第三位,是肝硬化患者的主要致死原因。近年随着内镜技术的提高,内镜下食管曲张静脉套扎及胃底静脉组织胶注射是治疗肝硬化食管胃底静脉曲张的安全有效方法,对于减少食管胃底静脉曲张再出血,改善其预后起到了明显的作用。我们对该治疗方法观察研究,现总结如下。 1资料与方法 1.1一般资料 随机选取北京友谊医院内镜中心自2006年11月至2007年12月间经内镜下套扎及组织胶注射治疗肝硬化食管胃底静脉曲张出血病人共76例,其中男48例,女28例,平均年龄48.2岁。肝功能Child分级:A级24例,B级39例,C级13例。采用中华消化内镜学会2003年10月济南食