内镜下注射组织粘合剂治疗胃底静脉曲张的临床分析

Clinical analysis of treatment of gastric fundus varices by injection of tissue adhesives under endoscope

目的探讨内镜下注射组织粘合剂治疗胃底静脉曲张的临床疗效和安全性。方法选择2008年4月～2009年4月胃镜检查确诊有上消化道出血或曾有出血史的46例胃底静脉曲张患者,在内镜下行组织粘合剂注射治疗术,每点注射组织胶1～2ml,每次注射1～3点。随访6个月,并对疗效及并发症进行评估。结果4例急诊内镜下注射治疗,注射后即刻止血成功,成功率100%。择期治疗42例,注射后可见曲张静脉团增粗、发白、变硬。随访6个月,复发出血5例(10.87%),所有患者无并发症发生。结论组织粘合剂注射治疗胃底静脉曲张效果确切,不仅可控制急性活动性出血,还可预防再出血,是一种简便、安全、有效的治疗方法。

Objective To explore the clinical efficacy and safety of endoscopic injection of tissue adhesives in the treatment of gastric fundus varices. Methods From April 2008 to April 2009,46 patients with upper gastrointestinal bleeding or a previous bleeding history who was finally diagnosed as gastric fundus varices under gastroscopy were enrolled in this study. They were given the endoscopic injection of tissue adhesives （histoacryl） at 1 - 2 ml each point and 1 - 3 point each time. All patients were followed - up for 6 months, and the therapeutic effects and complications were evaluated. Results The emergency injection stopped bleeding in 4 cases （achievement ratio 100% ）. Other 42 cases received selective treatment, and the clump of varices became thickened, white and hard following injection. The bleeding recurred in 5 cases （ 10.87% ） within 6 months after treatment. No complications were found in all cases. Conclusion The endoscopic injection of tissue adhesives （histoacryl） is a simple, safe and effective method in the treatment of gastric fundus varices.