经鼻内镜下行改良三腔二囊管合并硬化剂治疗食道静脉曲张破裂出血的临床疗效(附14例临床分析)

Endoscopic Modified by the Three-Cavity Tube 2 Capsule Combined Sclerotherapy of Esophageal Varices Bleeding Clinical Efficacy(Clinical Analysis of 14 Cases)

目的：观察经鼻内镜检查引导下通过改良三腔二囊管加沙氏导丝引导支撑,结合内镜下硬化剂治疗肝硬化食管静脉曲张破裂出血的疗效。方法：14例肝硬化食道静脉曲张破裂出血患者经过经鼻内镜检查后通过改良的三腔二囊管加沙氏导丝支撑下,结合内镜下硬化剂治疗食管静脉曲张破裂出血,观察止血效果以及并发症。结果：14例患者均1次止血成功,1例患者治疗后8 h再次出血,行急诊TIPSS手术治疗。主要反应为胸骨后疼痛,持续时间为2-7 d,对症处理后消失,3、6个月后再次复查食道胃底曲张静脉明显改善,3例10 d左右行内镜下再次硬化治疗（因第1次硬化剂量少或治疗不完全）。结论：经鼻内镜检查行改良三腔二囊管加沙氏导丝引导支撑下,结合内镜下硬化剂治疗肝硬化食管静脉曲张破裂出血是一种有效的治疗方法。

Objective： To investigate the nasal endoscopy guided through an improved three-cavity tube 2 capsule guide wire Gaza＇s support, combined with endoscopic sclerotherapy of esophageal variceal bleeding in cirrhotic patients. Methods： 14 cases of liver cirrhosis patients with esophageal variceal bleeding after nasal endoscopy after the adoption of an improved three cavity tube 2 capsule support Gaza＇s guide wire, the combination of endoscopic sclerotherapy of esophageal variceal bleeding, hemostatie effect observed and complications. Results：The results of 14 cases of bleeding in patients with 1 are successful, one cases of patients with bleeding again after 8 h, the TIPSS emergency surgery. The main reaction for substernal pain, duration of 2 - 7 d, symptoms disappeared after treatment, 3,6 months after the re-review of esophageal-gastric varices improved 10 d about three cases of endoscopic sclero therapy again （because of paragraph 1 hardening treatment dose of less than or incomplete）. Conclusion：The modified nasal endoscopy capsule pipe three-cavity second guide wire to guide the Gaza Strip＇s support, the combination of endoscopic sclerotherapy of esophageal variceal bleeding in cirrhotic is an effective treatment.