内镜套扎术急症止血治疗肝硬化食管静脉曲张破裂出血的疗效观察

An evaluation of emergent endoscopic variceal ligation in treatment of cirrhotic patients with acute esophageal variceal bleeding

目的探讨食管静脉曲张破裂出血的内镜套扎术急诊止血的疗效及安全性。方法对52例乙型肝炎肝硬化食管静脉曲张破裂出血患者实施内镜下急诊套扎止血术,观察术中、术后并发症,并于术后1月复查胃镜观察食管曲张静脉消失情况。结果51例(98%)患者急诊止血成功,1例(2%)止血失败,表现为术后6天内反复便血,转外科手术治疗;术后1月复查胃镜见21例(41.2%)静脉曲张消失或基本消失,28例(54.9%)中上段食管静脉曲张基本消失,2例(3.9%)存在显著的静脉曲张。术后常见并发症有咽下不适、胸骨后隐痛、低至中度发热,发生率为15.9%,未发生严重的并发症。结论急诊套扎术治疗食管静脉曲张破裂出血疗效可靠、安全性高。

Objective To evaluate the efficacy and safety of emergent endoscopic variceal ligation in cirrhotic patients with acute variceal bleeding. Method 52 patients with esophageal varices bleeding confirmed by emergent gastroendoscopy accepted emergent endoscopic variceal ligation,and the complications and esophageal varices eradication were evaluated. Result Bleeding was controlled in 51 （98%） patients,while one（2%） patient passed blood stool intermittently during post-treatment of 6 days. Gastroendoscopy l month later showed that 21 （41.2%）patients obtained nearly complete varices eradication,28 （54.9%） patients obtained upper and medial esophageal varices nearly complete eradication,and 2 （3.9%） patients still had remarkable varices. Complications rate was 15.9%,and there was no severe complications. Conclusion Emergent endoscopic variceal ligation is safe and effective in controlling acute esophageal variceal bleeding.