wardrobe内镜下静脉套扎和

胃底靶静脉，

“三明治”法注射，根据曲张静脉直径每点注入组织胶

1

～

2

ml

，

可多点注射。

自 胃食管黏膜连接处开始螺旋式结扎曲张静脉，

相邻结扎点距离约

2cm

左右，至曲张静脉口侧回缩变白为止。

结果

治疗后

8

周复查胃镜，食 管静

脉曲张总有效率为

88.6%< /p>

，胃底静脉曲张总有效率

75.1%

，无 异位栓塞发生，

2

例出现近期再出血，再次注射组织胶后血止， 其余患者均无再出血。

结论

内镜

下套扎联合组织胶注射治疗食管静脉曲张破裂出血疗效显著，

并发症 少，

具有临

床实用性。

Analysis on Endoscopic Variceal Ligation Combining with the Injection of

Histoacryl on 76 Ruptured Hemorrhage of Gastric Fundus Varices and

Esophagus Varices

Wu Zuoyan

1

Ji Ming

2

Beijing 6

th

Hospital

1

Beijing Frendship Hospital

2

[Abstract] Objective

:

To observe

the

clinical effect

of

endoscopic variceal ligation

combining with the injection of histoacryl on ruptured hemorrhage of gastric fundus

varices and esophagus varices.

Method

Random selected 76 patients

，

male 49, female

28,

average

age

48.2.

They

were

all

suffered

from

fundus

varices

and

esophagus

varices

caused

by

portal

hypertension,

and

all

suffered

ruptured

hemorrhage

not

before long. Endoscopic examination on routine, observed the condition of esophagus

varices and gstric fundus varices. Selecteded and injected target gastric fundus varices

with

“

sandwich

”

method,

Ligated

the

esophagus

varices

helicaly

from

esophagus-gastric

junction,

the

distance

between

tow

ligation

was

2

cm.

Results

Re-examined endoscope 8 weeks after treatment, the total effective rate of esophagus

varices

was

88.6%,

the

total

effective

rate

of

gastic

fundus

varices

was

75.1%,

no

ectopia

embolism

occurred,

2

patients

suffered

from

rehaemorrhagia,

and

stopping

bleeding

after

injection

histoacryl

again,

the

rest

patients

had

no

re- bleeding.

Conclusion

The method of endoscopic variceal ligation combining with the injection

of histoacryl has great effect on gastric fundus varices and esophagus varices, which

has clinical practicability.

[Key words]

endoscopic variceal ligation, histoacryl, varices, hemorrhage

食管胃底静脉曲张出血是消化内科常见的急危重症

占上消化道出血原因的

第三位

< br>,

是肝硬化患者的主要致死原因。

近年随着内镜技术的提 高

,

内镜下食管曲

张静脉套扎及胃底静 脉组织胶注射是治疗肝硬化食管胃底静脉曲张的安全有效

方法

,

对于减少食管胃底静脉曲张再出血

,

改 善其预后起到了明显的作用。

我们对

该治疗方法观察研究

,

现总结如下。

1

资料与方法

1.1

一般资料

随机选取北京友谊医院内镜中心自

2006

年

11

月至

2007

年

12

月间经内镜下

套扎及组织胶注射治疗肝硬 化食管胃底静脉曲张出血病人共

76

例

,

其中男

48

例

,