经胃镜行食管曲张静脉出血结扎治疗18例疗效分析

EFFICACY OF ENDOSCOPIC LIGATIONTO ESOPHAGEAL VARICEAL BLEEDING(EVL).

目的:了解胃镜下行食管曲张静脉出血结扎治疗的疗效,并与善得定治疗组进行对比分析。方法:用六连发皮圈套扎器随机对18例肝硬化并食管静脉曲张并出血的病人行结扎术,每次最多结扎10个皮圈,2-3周复查一次胃镜,如有曲张静脉再重复结扎,直至曲张静脉完全消除或在F1级以下;然后随机抽取23例同类病人用善得定0.1mg加入5%葡萄糖中持续静滴,按25ug/h的速度滴入或微泵泵入,2-3d后如出血停止即减量,逐渐停用。结果结扎治疗组曲张静脉消失或减轻总有效率88.9%,药物治疗组无曲张静脉消除,再出血率前者明显低于后者(16.7%比73.9%),随访期内存活率结扎治疗组明显高于药物治疗组(88.9%比39.1%)。结论:胃镜下结扎术是治疗食管曲张静脉出血的有效手段之一,可作为一理想选择。

Objective： To detdmine the result of endoscopic ligation to esophageal variceal variceal bleeding （EVB）. Methods： Ligated random 18 patints with cirrhosis and EVB by six deeding ligator, no more than 10 rubber bands were used to ligaate every treatment, endoscopic examination every two - week to three - weel, repeat hgate if the variceal colume is seen untial eradication of the varices was held or low of F1. Then treat random 23 patints with the same by Sandostatin that was added into 5% lucose and infused intravenously, in 25μg/h Sandtatin was reduced gradually until controlling active EVB, and it was stopped after two- day. Result： The rate in eradicating varices or relieving of EVL group was 88.9%, no eradication in Sandostatin, the rate of rebleeding was much lower in EVL （16.7v%s73.9%）, the rate of hving during follow- up in EVL Group was much higer than in medcine Group （88.9% vs39.1% ） . Conclusion： EVL is one of the most useful to EVB, and is optimal endoscopic method for treatment of EVB.