内镜下食管静脉曲张结扎与术后预防近期出血

The Endoscopic Esophageal Varices Ligation and the Recent Hemorrhage Prevention

目的探讨与研究内镜下食管静脉曲张结扎与术后预防近期出血的效果以及并发症。方法本文选择了80例肝硬化合并食管静脉曲张患者进行研究,在出血之后的72h内或者没有出血情况发生时选择适当时机对患者进行内镜下食管静脉曲张结扎。之后对患者进行胃镜的复查随访以及追踪,4周之内的结果作为近期治疗效果的判断标准,6个月以上的结果作为远期治疗效果的判断标准。结果手术之后食管静脉曲张的近期根治率为80%,其总有效率为85%。6个月之后对这些患者进行随访,这些患者的远期根治率为50%,其总有效率为78%,近期与远期治疗效果相比较存在明显的差异(P<0.05)。近期出血率以及病死率与远期相比较,不存在着显著的差异(P>0.05)。结论内镜下食管静脉曲张结扎近期的治疗效果确切,并且安全可靠。但是其远期的治疗效果并不是很乐观,通常其一定情况下需要反复的进行内镜下食管静脉曲张结扎治疗或者是手术治疗。

Objective Investigate and discuss the endoscopic esophagus varix ligation （EVL） and prevention of bleeding effects and complications at postoperative. Methods 80 cases of hepato-cirrhosis with moderate and serious hemorrhagic varix of esophagus underwent EVL at 7 h after bleeding or at a time when no bleeding was observed. Follow-up study and gastroscopy were made of the cases after the operation; results of the follow-up observations at 4 weeks were classified as evaluation of short-term effectiveness, and those at 6 months or later were classified as evaluation of long-term effectiveness. Results Short-term and total cure rates of esophagus varix were 80 and85% respectively call cases were followed up at 6 months, whose long-term and total cure rates were 50% and 78% respectively. There was a significant difference between the short-term cure rates and long-term cure rates （P〈0.05） whereas no significant difference （P〈0.05） was observed between short-term and long-term bleeding rates and death rates. Conclusion Short-term cure rate of EVL is distinct safe and reliable whereas long-term cure rate is not so desirable for which several EVLs or surgical operation are needed.