摘要
目的 探讨经硬化剂治疗食管静脉曲张破裂出血后的远期疗效。方法 1996～2003年在内镜下用硬化剂(1％乙氧硬化醇)注射治疗15例食管静脉曲张破裂出血患儿,年龄3～14岁,采用静脉内和静脉旁联合注射。注射后长期临床与内镜随访,观察再出血率及曲张静脉消失率与并发症发生率。结果15例共作了43次硬化剂注射治疗,依治疗时间先后不同,随访时间从3年4个月到7年2个月不等,平均5年6个月。10例经2次治疗,5例经3次治疗,曲张静脉基本消退,内镜随访发现曲张静脉平均消退时间为3～6个月。15例长期随访发现仅3例曲张静脉复发。再出血率明显减少,15例中仅3例发生再出血,其中2例因长期失访,直至再出血来院检查,发现1例系十二指肠溃疡,1例为静脉曲张出血,而治疗前几乎每1—2个月出血1次。此外未见一例食管穿孔、食管狭窄的并发症。结论 食管静脉曲张硬化剂疗法治疗儿童食管静脉曲张安全有效,尤其是肝外血管畸形所致的门脉高压症效果显著,是挽救患儿生命,提高患儿生命质量的有效内科治疗方法。
Objective Endoscopic sclerotherapy has emerged as an effective treatment for bleeding esophageal varices in adults and children but the long-term outcome is poorly defined in children. The present study aimed to study the long-term effect of endoscopic sclerotherapy in children with portal hypertention. Methods Fifteen patients (age 3 to 14 years) with esophageal variceal bleeding underwent endoscopic injection treatments with 1% Aethoxy-sclerol since 1996. All subjects continued to receive the therapy by repeated intra and extravariceal endoscopic sclerotherapy at intervals of 3-4 weeks until the varices disappeared, and received regular endoscopic follow-up. Results Fifteen patients had totally 43 injections, and were followed up from 40 to 86 months ( mean 66 months) by endoscopy. Two patients received 2 injections and 5 received 3 before eradication of varices. The mean time needed for varices eradication was 3 to 6 months. Recurrence of varices and bleeding was seen in 3 patients who had duodenal ulcer. Conclusion Endoscopic sclerotherapy is a safe and effective treatment for pediatric esophageal varices.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2004年第8期574-576,共3页
Chinese Journal of Pediatrics
