您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版)

• 临床医学 • 上一篇    下一篇

血管内血管旁联合注射硬化剂治疗食管静脉曲张出血

吴善彬,许洪伟,刘慧,李宾   

  1. 山东大学附属省立医院消化科, 山东 济南 250021
  • 收稿日期:2013-11-27 出版日期:2014-06-10 发布日期:2014-06-10
  • 通讯作者: 许洪伟。 E-mail:xu_hong_wei@sina.com

Endoscopic injection sclerotherapy performed both by intravariceal and paravariceal injection for esophageal variceal hemorrhage#br#

WU Shanbin, XU Hongwei, LIU Hui, LI Bin   

  1. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University,
    Jinan 250021, Shandong, China
  • Received:2013-11-27 Online:2014-06-10 Published:2014-06-10

摘要: 目的  观察血管内血管旁联合注射硬化剂治疗食管静脉曲张出血的安全性及疗效。方法  101例胃镜证实食管静脉曲张出血并行内镜下硬化剂注射 (EIS)的患者,根据硬化剂注射方法  分为血管内血管旁联合注射组(简称联合注射组)和血管内注射组。术后随访2年,比较两组的治疗效果及并发症。结果  联合注射组与血管内注射组的止血成功率(100.00% vs 96.88%)、早期复发出血率 (6.12% vs 11.54%)、静脉曲张消失率 (81.63% vs 78.85%)、 2年生存率(81.63% vs 76.92%)及并发症均无统计学差异(P>0.05),但联合注射组远期复发出血率低于血管内注射组(14.28% vs 30.77%, P<0.05)。所有患者无食管穿孔、ARDS、异位栓塞等严重并发症。结论  内镜下硬化剂注射治疗食管静脉曲张出血安全、有效,血管内血管旁联合注射硬化剂远期止血效果优于单纯血管内注射。

关键词: 食管静脉曲张出血, 血管内血管旁联合注射, 血管内注射, 内镜下硬化剂注射治疗, 肝硬化

Abstract: Objective  To evaluate the efficacy and safety of endoscopic injection sclerotherapy (EIS) performed both by intravariceal and paravariceal injection for esophageal variceal hemorrhage. Methods  One hundred and one patients with esophageal variceal hemorrhage had received the sclerotherapy. According to different treatment Methods  , they were divided into combined injection group and intravariceal injection group. The combined injection group underwent EIS both by intravariceal and paravariceal injection, while the intravariceal injection group underwent EIS only by intravariceal injection. The clinical effect between the two groups was evaluated after two years follow-up. Results  No significant difference was found between the two groups in bleeding control (100.00% vs 96.88%), early re-bleeding rate (6.12% vs 11.54%), varices elimination (81.63% vs 78.85%), survival rate in two years (81.63% vs 76.92%) and complications(all P>0.05). But the late re-bleeding rate of the combined injection group was remarkably lower than that of the intravariceal injection group (14.28% vs 30.77%, P<0.05). No serious complications such as esophageal perforation, ARDS and ectopic embolism were observed in the two groups. Conclusion  EIS is effective and safe for esophageal variceal hemorrhage. EIS performed by combination of intravariceal and paravariceal injection can decrease the late re-bleeding rate remarkably.

Key words: Intravariceal and paravariceal injection, Esophageal variceal hemorrhage, Liver cirrhosis, Endoscopic injection sclerotherapy, Intravariceal injection

中图分类号: 

  • R573.2
[1] 王韶卿 刘毅慧 付婷婷 成金勇 刘强. 肝癌31磷磁共振波谱数据的分类[J]. 山东大学学报(医学版), 2209, 47(6): 42-46.
[2] 张琨,张孝国,崔杏杏,陈士俊. 慢性HBV感染者外周血单个核细胞凋亡相关因子的表达及其与乙肝慢性化的关系[J]. 山东大学学报(医学版), 2016, 54(7): 38-42.
[3] 刘彩峰, 汪明明, 李新立, 崔速南. 托伐普坦治疗肝硬化顽固性腹水并低钠血症的疗效[J]. 山东大学学报(医学版), 2016, 54(1): 33-37.
[4] 黄旻. 肝硬化上消化道出血的内科治疗方法探讨[J]. 山东大学学报(医学版), 2014, 52(S2): 24-24.
[5] 吴斌, 何文涛, 程云峰, 章以法, 吴东刚. 肝硬化患者血清高密度脂蛋白胆固醇检测的临床意义[J]. 山东大学学报(医学版), 2014, 52(S2): 19-19.
[6] 刘士锦. 肝硬化合并上消化道出血患者的观察与护理[J]. 山东大学学报(医学版), 2014, 52(S2): 130-131.
[7] 李继业, 王薇, 潘润华, 阿斯楞, 廖彩仙. 肝脏FibroScan测定和功能评分与肝硬化病理分级的相关性[J]. 山东大学学报(医学版), 2014, 52(12): 83-88.
[8] 刘伟1,丁艾昆2,李程2,单容3,王昌源1,2. 慢性乙型肝炎疾病进展中瞬时弹性波检测的意义及其影响因素[J]. 山东大学学报(医学版), 2014, 52(1): 85-88.
[9] 杨洋1,2,杜文军2,史兆章2,郑昭敏2,陈士俊2. 经皮微波固化治疗小肝癌复发及生存时间的影响因素分析[J]. 山东大学学报(医学版), 2014, 52(1): 89-94.
[10] 张永明1,孟珂伟2,黄庆先2,高辉3,董梅4,周先亭2,李绍军2,谢广顺5,汤义军6. 肝硬化大鼠全肝血流阻断不同时间肺损伤的改变[J]. 山东大学学报(医学版), 2011, 49(9): 56-.
[11] 崔海彬1,崔速南2,汪明明2,张秀珍2,刘葵花2,郭楠1. 血浆渗透压评分对肝肾综合征的预后评价[J]. 山东大学学报(医学版), 2011, 49(6): 103-106.
[12] 单容1,王爱光2. Fibroscan在乙肝相关肝纤维化诊断中的临床应用研究[J]. 山东大学学报(医学版), 2010, 48(9): 93-96.
[13] 张俊勇1,蒯京华1,秦成勇1,李玮2. 血清钠与肝硬化并发症及其预后的关系[J]. 山东大学学报(医学版), 2010, 48(11): 109-112.
[14] . 31P-MR波谱对肝硬化时骨骼肌能量代谢的评估[J]. 山东大学学报(医学版), 2009, 47(7): 74-77.
[15] 王韶卿 刘毅慧 付婷婷 成金勇 刘强. 肝癌31磷磁共振波谱数据的分类[J]. 山东大学学报(医学版), 2009, 47(6): 42-46.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!