密集多点结扎术治疗肝癌合并食管曲张静脉急性出血疗效观察

Effection of dense endoscopic ligation on esophageal varices bleeding with primary hepatocellular carcinoma

目的探讨内镜下密集多点结扎术(DEVL)治疗原发性肝癌合并食管曲张静脉急性出血的临床疗效。方法采用内镜下密集多点结扎术治疗原发性肝癌合并食管静脉曲张急性出血患者58例。急性出血控制后,每隔2周重复治疗,直至曲张静脉完全根治。结果50例完成全部结扎治疗,共完成146次、1141点结扎,平均每例结扎2.9次、22.8点。急诊止血率91.4%,近期再出血率20.7%,曲张静脉根治率为82%。结论内镜下密集结扎术能有效地治疗原发性肝癌合并食管静脉曲张急性出血,根治食管曲张静脉和预防再出血。DEVL治疗不受肝功能的影响,并发症少。

[Objective] To evaluate the effects of dense endoscopic variceal ligation （DEVL） for bleeding varices with primary hepatocellular carcinoma（PHC）. [Methods] DEVL was performed in 58 patients with acute bleeding varices and PHC. Following the initial control of bleeding, DEVL was repeated at a two week interval until varices was eradicated. [Results] 50 patients underwent DEVL with 146 sessions and 1141 ligations; each patient was treated with a mean of 2.9 sessions and 22,8 points, Variceal bleeding was controlled in 54 patients（91.4%）. Variceal rebleeding occurred in 12 patients （20.7%） and varices was eradicated in 41（82%） patients. [Conclusion] DEVL was effective in treating acute bleeding esophageal varices with PHC and also in variceal eradication and prevention of variceal rebleeding,