Histoacryl-生理盐水混合液治疗食管胃静脉曲张及其出血

HistoacryI-NS fluid treatment of esophageal gastric Varices and its bleeding

目的探讨经内镜 Histoacryl-生理盐水混合液注射治疗食管和(或)胃静脉曲张及其出血方法应用粘合剂 Histoacryl-生理盐水混合液治疗24例食管胃静脉曲张及其出血;对照组为30例食管静脉曲张硬化剂治疗者。观察两组的止血作用、针孔出血及并发症.结果 Hstoacryl-生理盐水混合液治疗12例急性出血者均获成功止血(100%).全组24例患者曲张静脉注射针孔均无出血.6例注射针芯被粘合剂堵塞,未见任何并发症.硬化剂注射组5例(16.7%)发生针孔明显出血.两组相比差异显著(P<0.01).结论 Histoacryl-生理盐水混合液可延长粘合剂固化时间,有利于内镜下食管胃静脉曲张及其出血的治疗,但仍有25%的患者发生注射针芯堵塞,应进一步改进操作方法.Histoacryl-生理盐水混合液曲张静脉注射针孔均无出血,明显少于硬化剂注射针孔16.7%的出血发生率.

AIM To study the clinical value of HistoacryI-NS fluid under the endoscopy in treating esophageal-gastric varices and its bleeding. METHODS Twenty-four cases of esophageal and/or gastric varices and bleeding were treated with Histoacryl- NS fluid,30 cases of esophageal varices received sclerotherapy with 1% polidocanol. ERSULTS No haemorrage from the variceal needle holes occurred in all cases treated with HistoacryI-NS fluid. Nevertheless,6 needle canals were obstructed by adhesive tissue agents,without any complications. Twelve cases with acute variceal bleeding were controled successfully after injection of HistoacryI-NS fluid,and 5 cases(16.7%)in sclerotherapy group had puncture hole bleeding(P<0.01). CONCLUSION HistoacryI-NS fluid could postponed the solidification of the adhesive tissue agent and it was favourable to endoscopic treatment for esophagogastric varices and its bleeding,but it still had 25% patients having needle canal obstruction.As to the puncture hole bleeding,HistoacryI-NS fluid was obviously superior to the sclerotherapy.