内镜多环结扎器食管静脉结扎术

采用内镜多环结扎器行食管静脉曲张结扎术治疗食管静脉曲张出血62例．治疗有效率96．8％，急诊止血率100％，无严重并发症。随访3～16月（平均7．4月）．复发出血率7．6％，作者认为此法较单环结扎器治疗，其方法更先进，操作更简单，创伤性更小．更具安全性，避免了单环结扎器治疗时引起的诸多井发症。尤其适宜急诊止血和食管短小．易痉挛，对治疗反应重，耐受性差的危、重病人以及未成年的患者。内镜多环会扎器的发明和使用是内镜下食管静脉曲张结扎术的一次飞跃。

内镜结扎术治疗食管静脉曲张急性出血

采用内镜结扎术(EVL)治疗食管静脉曲张急性出血78例。首次EVL的实施距出血发作时间:8h以内10例,9～48h 26例,49～72h 37例,超过72h 5例。急性出血被控制后,每隔2周重复EVL直至静脉曲张被根除或缩小至Ⅰ°以下。经该法治疗,近期止血率达93.6％;63例生存病人经平均4次(2～7次)EVL,55例(87％)食管静脉曲张被根除或缩小至Ⅰ°以下;未发现与EVL有关的严重并发症。平均随访25月(8～48月),有11例病人复发出血(17％),这些再出血大多发生在曲张静脉根除之前,且容易被重复EVL控制出血。该组结果显示:EVL止血效果确切,安全易行,并发症少;对食管静脉曲张急性出血,尤其伴有肝功能不良者,EVL可作为首选的有效治疗方法。

“三腔管牵引器”的应用和体会

This article introduced "Sengstaken-Blakemore tube tractor". In these 3 years,we’ d got good effect in clinical application and some knowledge from practice. This new apparatus has the special features as fellows: accurate traction force;Sengstaken-Blakemore’s tube move-out alarm system; less possible to cause nasal mucosa injury; easy for installation; decrease of the nursing; reduction of Iubricated tube before use, otherwise the traction will be a failure. By now, this apparatUS has been regarded as recommending product by Chinese Emergency Association. We hope to get all our colleague’s great support during the popularization of clinical application.