食管静脉曲张破裂大出血的急诊硬化治疗

Emergent sclerotherapy in massive hemorrage from esophagogastric varices

目的 总结食管静脉曲张破裂大出血极危重患者在急诊内镜下行硬化治疗(EIS)的经验。方法 176例食管静脉曲张破裂大出血患者在改良三腔管牵引下,共用5％鱼肝油酸钠食管静脉内注射209次,其中181次为致死性活动性大出血。结果 首次EIS能明确出血部位166例(94.3％),急诊EIS止血成功201次(96.2％),其中21例为多次EIS后止血,并发症15例(8.5％),死亡3例(1.7％)。结论 改良三腔管牵引下行EIS是急诊救治致死性食管静脉曲张大出血的安全、有效、简便方法。

Objective To evaluate the effective of emergent endoscopic injection sclerotherapy ( EIS) for lethal bleeding from esophagogastric varices. Methods In this study, endoscopic injection of 5% sodium morrhuate was used to control esophagogastric variceal bleeding in 176 patients. In all 209 cases, 181 cases suffered from acute lethal bleeding from esophagogastric varices received endoscopic variceal sclerotherapy under the modified Senstaken-Blakemore tube compression. Results The exact bleeding site at the first procedure could be visualized in 166(94. 3% ) patients. The effective rate of EIS was 96. 2% . Multiple procedures were required in the 21 cases of relapsed bleeding. Complications of EIS occurred in 15 cases (8. 5% ) , of which 3(1. 7% ) died. Conclusion Endoscopic injection sclerotherapy under the modified Senstaken-Blakemore tube compression is relatively safe and effective procedure in the treatment of lethal bleeding from esophagogastric varices.