短期内反复内镜治疗难治性食管静脉曲张破裂大出血

Repeated Endoscopic Treatment of Intractable Bleeding Esophageal Varices by Sclerotherapy and Tissue Adhesive Injection in a Short Period

目的:探讨食管静脉曲张破裂大出血急诊硬化治疗术后仍持续出血的再次内镜下处理。方法:52例食管静脉曲张破裂大出血首次硬化术后仍出血不止或于1周内再次大出血患者,插入二腔一囊管后牵拉,再次进行硬化或(和)组织黏合剂黏堵治疗。结果:再次硬化治疗41例,黏堵加硬化治疗11例,无效转外科手术1例,死亡2例。急诊止血率为94.2%。发生较重并发症7例。结论:内镜下反复硬化或(和)黏堵治疗是控制难治性食管静脉曲张破裂大出血的首选抢救措施。

Objective：To evaluate the effect of repeated endoscopic sclerotherapy and tissue adhesive injection for intractable bleeding esophageal varices in a short period.Methods： A total of 52 patients with hepatic cirrhotic esophageal varices were bleeding persistently or rebleeding in just one week after first emergent endoscopic sclerotherapy.So repeated endoscopic sclerotherapy and tissue adhesive injection were carried out under modified S-B tube to control bleeding.Results： Repeated sclerotherapy were 41 cases,sclerotherapy and tissue adhesive injection 11 cases,1 case of no valid was emergently operated on,2 cases of death.The emergent hemostatic rate was 94.2%,7 cases suffered from severe complications.Conclusions： Repeated endoscopic sclerotherapy and tissue adhesive injection in a short period is of choice for intractable hepatic cirrhotic esophageal bleeding in controlling hemorrhage.