内镜下硬化剂联合组织黏合剂治疗食管胃底静脉曲张破裂出血疗效观察
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摘要
目的观察内镜下硬化剂联合组织黏合剂治疗食管胃底静脉曲张破裂出血的疗效。方法对67例食管胃底静脉曲张破裂出血患者进行硬化剂和组织黏合剂联合治疗,观察其临床疗效、并发症等情况。结果 11例急诊内镜下治疗,全部止血,急诊止血率达100%。67例患者中食管静脉曲张总有效率85.00%,胃底静脉曲张总有效率74.07%。术后4周内不良反应较少,主要有轻中度胸痛16例,上腹不适8例,发热4例,胸腔积液1例,无异位栓塞及其他严重并发症。结论内镜下硬化剂联合组织黏合剂治疗食管胃底静脉曲张破裂出血疗效好,不良发应少,具有较好的临床推广价值。
Objective To observe the curative effect of sclerosing agent combined with tissue adhesives in the treatment of esophageal and gastric fundus variceal hemorrhage under endoscopy guidance. Methods Sixty-seven patients with esophageal and gastric fundus variceal bleeding were treated with a combination of sclerotherapy and tissue adhesives.The clinical effects and complications were observed. Results Eleven cases were treated with emergency endoscopic hemostasis,and the emergency hemostasis rate was 100%.Among the67 patients,the total effective rate of esophageal varices was 85.00%,and that of gastric fundus varices was 74.07%.Within 4 weeks after surgery,there were few adverse reactions,including 16 cases of mild to moderate chest pain,8 cases of upper abdominal discomfort,4 cases of fever,and 1 case of pleural effusion.No ectopic embolism and other serious complications occurred. Conclusion Endoscopic sclerosing agent combined with tissue adhesives in the treatment of esophageal and gastric fundus varices bleeding has a good treatment result,less adverse reactions,and a good clinical promotion value.
Objective To observe the curative effect of sclerosing agent combined with tissue adhesives in the treatment of esophageal and gastric fundus variceal hemorrhage under endoscopy guidance. Methods Sixty-seven patients with esophageal and gastric fundus variceal bleeding were treated with a combination of sclerotherapy and tissue adhesives.The clinical effects and complications were observed. Results Eleven cases were treated with emergency endoscopic hemostasis,and the emergency hemostasis rate was 100%.Among the67 patients,the total effective rate of esophageal varices was 85.00%,and that of gastric fundus varices was 74.07%.Within 4 weeks after surgery,there were few adverse reactions,including 16 cases of mild to moderate chest pain,8 cases of upper abdominal discomfort,4 cases of fever,and 1 case of pleural effusion.No ectopic embolism and other serious complications occurred. Conclusion Endoscopic sclerosing agent combined with tissue adhesives in the treatment of esophageal and gastric fundus varices bleeding has a good treatment result,less adverse reactions,and a good clinical promotion value.
引文
[1]王萍,王拱辰.肝硬化食管胃底静脉曲张出血治疗进展[J].中国肝脏病杂志(电子版),2013,5(3):61-63.
[2]徐榕.循证护理在预防食管胃底静脉曲张出血患者中的应用效果[J].中外女性健康研究,2017,(23):138,153.
[3]宋文玲,王艳凤,孙绍杰,等.食道胃底静脉曲张注射聚桂醇组织黏合剂方法的改进[J].黑龙江医药科学,2016,39(2):128-129.
[4]程晓娜,王丹.硬化剂配合组织黏合剂治疗食管胃静脉曲张破裂出血63例远期效果观察[J].海南医学,2015,26(9):1259-1261.
[5]冯姝婷,由继辉,李艳.内镜下组织黏合剂联合硬化剂对危重食管胃底静脉曲张患者门静脉血流动力学的影响[J].检验医学与临床,2018,15(5):711-714.
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[9]周江伟,林叶素,林细州,等.内镜下套扎与硬化剂治疗食管静脉曲张破裂出血疗效的Meta分析[J].中国内镜杂志,2017,23(1):39-46.
[10]杨云生,刘庆森.实用消化内镜新技术[M].北京:人民军医出版社,2006:60-66.
[11]耿庆亚,项小燕,王琨,等.内镜套扎术联合硬化术治疗食管静脉曲张破裂出血的疗效研究[J].胃肠病学,2015,20(4):241-243.
[12]赵永辉,罗文静,赖官斌.食管曲张静脉出血硬化剂注射治疗的疗效及并发症研究[J].中国现代药物应用,2017,11(13):27-28.
[13]倪猛,张海洋.内镜下套扎联合硬化剂注射治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者疗效及其再出血危险因素分析[J].实用肝脏病杂志,2018,21(2):241-244.
[14]赵宇.预防食管胃静脉曲张破裂出血内镜治疗并发症的研究进展[J],中国医疗器械信息,2017,23(12):23-24.
[2]徐榕.循证护理在预防食管胃底静脉曲张出血患者中的应用效果[J].中外女性健康研究,2017,(23):138,153.
[3]宋文玲,王艳凤,孙绍杰,等.食道胃底静脉曲张注射聚桂醇组织黏合剂方法的改进[J].黑龙江医药科学,2016,39(2):128-129.
[4]程晓娜,王丹.硬化剂配合组织黏合剂治疗食管胃静脉曲张破裂出血63例远期效果观察[J].海南医学,2015,26(9):1259-1261.
[5]冯姝婷,由继辉,李艳.内镜下组织黏合剂联合硬化剂对危重食管胃底静脉曲张患者门静脉血流动力学的影响[J].检验医学与临床,2018,15(5):711-714.
[6]陈强,刘迎娣.内镜下组织黏合剂联合硬化剂注射治疗食管胃底静脉曲张的疗效观察[J].中国煤炭工业医学杂志,2012,15(2):214-215.
[7]孙鑫,宋明全.食管胃底静脉曲张破裂出血内镜下治疗进展[J].世界华人消化杂志,2018,26(26):1562-1566.
[8]黄理哲,廖清华.门静脉高压症食管胃底静脉曲张破裂出血临床治疗进展[J].右江民族医学院学报,2008,30(1):128-130.
[9]周江伟,林叶素,林细州,等.内镜下套扎与硬化剂治疗食管静脉曲张破裂出血疗效的Meta分析[J].中国内镜杂志,2017,23(1):39-46.
[10]杨云生,刘庆森.实用消化内镜新技术[M].北京:人民军医出版社,2006:60-66.
[11]耿庆亚,项小燕,王琨,等.内镜套扎术联合硬化术治疗食管静脉曲张破裂出血的疗效研究[J].胃肠病学,2015,20(4):241-243.
[12]赵永辉,罗文静,赖官斌.食管曲张静脉出血硬化剂注射治疗的疗效及并发症研究[J].中国现代药物应用,2017,11(13):27-28.
[13]倪猛,张海洋.内镜下套扎联合硬化剂注射治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者疗效及其再出血危险因素分析[J].实用肝脏病杂志,2018,21(2):241-244.
[14]赵宇.预防食管胃静脉曲张破裂出血内镜治疗并发症的研究进展[J],中国医疗器械信息,2017,23(12):23-24.