单气囊压迫硬化剂治疗食管静脉曲张出血

Treatment of bleeding esophageal varices with one balloon tamponade and sclerosant injection

目的 探讨单气囊压迫和注射硬化剂治疗食管静脉曲张出血。方法 胃镜前端弯曲部附着气囊 ,插镜后 ,在食管所注射的静脉上方给予气囊充气压迫 ,阻止所注射的硬化剂反流。注射后 ,推镜使气囊下移 ,压迫针孔 1～ 2 min,预防或控制出血。一般选 3～ 4条曲张的静脉依次注射 ,每条曲张静脉注射硬化剂 5～ 10 m l。结果 约90 %的急性出血可以被控制。通常经 4～ 5次治疗 ,曲张的静脉可以闭塞。结论 气囊压迫使食管曲张的静脉血流暂时阻断 ,硬化剂不被稀释 ,有利于止血 ,气囊压迫针孔预防针孔出血。这种方法比没有气囊压迫安全 ,并可减少肺部并发症。

Objective To study the treatment of bleeding of esophageal varices with one balloon tamponade and sclerosant injection.Methods The curved part of gastroscopic tip attached to balloon.When the gastroscope went into the esophagus above injected varices the balloon was filled air and then tramponaded to prevent the injected sclerosant from refluent.After injection,We pushed down the balloon and tamponaded pinprick for one or two minutes to prevent or control bleeding.Usually three or four varices were injected in turn,with sclerosant 5～10 ml for each varice.Results About 90% of acute bleeding could be controlled.The varices could be obliterated after 4～5 times of treatment.Serious complication have not occured.Conclusion Balloon tamponade temporarily can block blood flow,decrease variceal blooding and thus favour sclerosant injected into the varices.It is safer than that non balloon tamponade and might decrease complications of the lung.