预防性套扎治疗肝硬化重度食道静脉曲张的临床研究

Clinical Study of Endoscopic Variceal Ligation Prevention Treatment to Cirrhosis with Sever Varices

目的:探讨重度食道静脉曲张的有效治疗方法。方法:重度食道静脉曲张但未发生过上消化道出血肝硬化患者103例依照自愿原则进行预防性套扎治疗(63例)或不进行套扎治疗(40例),按肝功能Child-pugh分级A、B、C分别观察疗效。结果:进行预防性套扎患者A级29例患者2年内无1例发生上消化道出血,B级24例患者2年内发生上消化道出血5例,c级10例患者2年内发生上消化道出血4例并死亡;未进行预防性套扎患者A级20例患者2年内发生上消化道出血9例,B级13例2年内发生上消化道出血10例死亡5例,C级7例患者2年内发生上消化道出血7例均死亡。结论:预防性套扎最大限度地防止肝硬化重度食道静脉曲张患者发生曲张静脉破裂出血或延缓首次出血出现的时间,是治疗肝硬化重度食道静脉曲张的安全、可靠的有效方法。

Objective：To investigate the effect of preventive EVL for sever esophageal varices. Methods：One hundred and three patients with sever esophageal variees in liver cirrhosis were assigned by self-imposed into two groups： sixty-three patients were treated by EVL,forty patients were not treated by EVL. The effect was observed respectively by Child-pugh A, B and C classification. Results：In the group of patients treated by EVL, non of twenty-nine patients with Child-pugh A had bleeding in two years after EVL, five of twenty-four patients with Child-pugh B had bleeding in two years after EVL, four of ten patients with Child-pugh C had bleeding in two years after EVL and the four patients died. In the group of patients no treated by EVL, nine of twenty patients with Child-pugh A had bleeding in two years after EVL, ten of thirteen patients with Child-pugh B had bleeding in two years after EVL and five patients died, seven of seven patients with Child-pugh C had bleeding in two yeras after EVL and the seven patients died. Conclusion： EVL could prevent to treat sever esophageal varices in liver cirrhosis, it prevent the varices bleeding or delay the time of the esophageal varices bleed happening. It might be safety and efficiency method for prevent bleeding of sever esophageal varices in liver cirrhosis.