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