硬化剂注射治疗食管静脉曲张破裂出血的疗效

Efficacy of endoscopic injection sclerotherapy in treating esophageal varices bleeding

目的探讨内镜下硬化剂注射治疗食管静脉曲张破裂出血的疗效。方法食管静脉曲张破裂出血患者157例,24h内行内镜下注射5%鱼肝油酸钠或1%聚桂醇治疗。观察治疗结果及并发症发生情况。结果 157例中,1次治疗出血停止者150例(95.5%),其中包括术中出血采用镜身压迫破口以及局部注射少量组织胶后出血停止者。7例未能止血者中,6例行三腔二囊管压迫止血,短期内未再出血;1例止血失败死亡。出现的并发症包括术中短暂出血42例(26.8%)、胸痛30例(19.1%)、低热20例(12.7%)、注射点糜烂或溃疡9例(5.7%)和食管穿孔1例(0.6%)。结论内镜下硬化剂注射治疗食管静脉曲张破裂出血疗效好,操作简便和安全。

Objective To evaluate the efficacy of endoscopic injection sclerotherapy（EIS） in the treatment of esophageal variceal bleeding. Methods EIS with 5% sodium morrhuate or 1% lauromacrogol was conducted within 24 hours after the onset of bleeding in the patients with esophageal variceal bleeding. The efficacy and complications were observed. Results Of 157 patients, bleeding was stopped after one time EIS in 150 cases（95.5%）. The bleeding was not stopped after one time EIS in 7 cases, of whom bleeding was stopped by balloon tamponade with Sengstaken-Blakmore tube in 6 cases and one case died from haemorrhage. The complications included transient bleeding at injection points in 42 cases（26.7%） ,chest pain in 30 cases（19. 1%） ,slight fever in 20 cases（12.7%）, erosion and ulceration of mucous membrane in 9 cases（5. 7%） and esophageal perforation in one case （0. 6%）. Conclusion EIS is an effective, safe and simple therapeutic method in the treatment of esophageal variceal bleeding.