内镜下结扎食管静脉曲张的疗效评估:216例临床分析

Evaluation on Efficacy of Endoscopic Ligation of Esophageal Varices

作者采用内镜结扎术治疗216例食管静脉曲张病人,其中69例有急性出血,经此方法治疗后,即时止血率达92.8％。经3～5次结扎后,其中80％的食管静脉曲张消失或缩小至Ⅰ°以下。未发生与结扎术有关的严重并发症。随访4～40个月(平均16月),出血复发率为17.1％,有25例死亡。结果表明:内镜结扎术疗效好,操作方便,并发症少,可适用于肝功能差、不能耐受手术以及手术后或硬化剂治疗后食管静脉曲张复发出血的病人。

Background/Aims: Endoscopic variceal ligation (EVL) was developed as alternative to endoscopic variceal sclerosis (EVS) because of high complication rate seen in EVS. The aim of this study was to evaluate the therapeutic and side effects of EVL. Methods: 216 patients with esophgeal varices were treated with EVL. Results: Bleeding was controlled in 64 of 69 patients (92.8%) who were actively bleeding at endoscopy. Varices were eradicated or reduced to grade one in 173 of 218 patients (80%) after consecutive 3 to 5 procedures. No major ligation related complications were observed. A follow-up period ranged from 4 to 40 months showed that 25 patients died during the study. The cause of death was hepatic failure in 10, hepatic cancer in 9, and hemorrhage in 6. Recurrent bleeding occured in 17.1% of all patients. Conclusion: These data suggested that EVL is a safe, effective and rather simple method for treating esophageal varices, especially in patients with poor liver function and recurrent bleeding after devascularization and shunt surgery.