急诊内镜下套扎应用于肝硬化食管静脉曲张破裂出血的疗效及安全性评价

The clinical observation of the efficacy and safety of emergency endoscopic ligation in the treatment of cirrhosis patients with esophageal varices

目的观察急诊内镜下套扎(EVL)治疗肝硬化食管静脉曲张破裂出血的疗效及并发症,评估其安全性。方法对68例肝硬化食管静脉曲张破裂出血患者进行EVL治疗,从胃食管连接处开始螺旋向上套扎曲张静脉;当有活动性出血,首先套扎出血处静脉,如止血不成功,则在其下方套扎;如出血较多视野不清,则从胃食管连接处盲扎。观察止血效果及并发症。结果急诊止血成功率为94.12%(64/68),术中并发症发生率为10.29%(7/68),术后并发溃疡出血发生率为2.92%(2/68),无死亡发生。结论 EVL是一种快速、有效的止血方法,但术中并发症并不少见,应重视术中误吸、出血等并发症。

Objective To observe the therapeutic effects and complication of emergency endoscopic ligation in the treatment of cirrhosis patients with esophageal varices and evaluate the safety of it. Methods 68 patients with cirrhotic esophageal varices bleeding were treated with EVL. EVL were spirally upward started from the gastroesophageal junction;The varices was ligated first when it was active bleeding ; If the homeostasis was unsuccessful, the varices was ligated inferiorly ; If the field of bleeding was too much and unclear, the variees was ligated blindly from the gastroesophageal junction. Results The emergency homeostasis rate of EVL was 94.12% （64/ 68 ） ,The rate of complication during EVL was 10.29% （7/68） , The rate of complication of bleeding from esophageal ulcer after EVL was 2.92% （2/68） ,no deaths occurred. Conclusion The emergency EVL is fast and effective in the treatment of esophageal varices bleeding, Intraoperative complications are not uncommon, and the intraoperative complication such as suffocation and bleeding should be stressed.