内镜下套扎法在食管静脉曲张出血中的临床应用

The Clinical Application of Endoscopic Variceal Ligation in the Management of Variceal Bleeding

内镜下硬化疗法为一消除曲张食管静脉，治疗其急性出血的有效方法。但因有许多严重并发症如胸痛发热菌血症、胸膜浸润、食管穿孔及食管狭窄等，故并非理想疗法。而近来兴起的内镜下食管静脉套扎（ＥＶＬ）不仅可以清除曲张的食管静脉，而且可以防止硬化疗法的上述副作用。本文５６例肝硬化食管静脉曲张破裂出血患者进行了ＥＶＬ治疗，其中３６例患者随访观察１８个月，４例进行了急诊ＥＶＬ治疗。结果显示急诊止血率为７５％，显效率６９．４％，有效率为８８．８％，每人年平均出血次数由结扎前的１．３５次减少为０．１８次，其疗效至少和硬化方法相同。该法操作简单、容易、安全、并发症少，应该在临床上推广应用。

Endoscopic sclerotherapy is an effective method for treating eradicating acutely bleeding varices,but it is not ideal because of numerous serious complications such as chest pain,rise in temperature,bacteremia,pleural effusion,perforation of the esophagus and esophageal stricture, Endoscopic variceal ligation ( EVL ) can overcome some of the side effects of sclerotherapy. In this article, 56 patients of esophageal varices were treated with EVL,After EVL of 18 months among those cases, 36 patients were follow-up.The results showed that the effective rate were 88.8%。 Acute hemostatic rate were 75%. The mean bleeding times of every patient from 1. 35/ year reduce to 0.18/ year. After EVL,this method is easier,safer and simple. EVL is at least as effective as sclerotherapy. It sould be recommended to clinical use and complications were very rare.