摘要
目的探讨内镜下密集多点结扎术(DEVL)治疗食管静脉曲张出血的近远期疗效。方法对贲门口齿状线及以上5～6cm范围的曲张静脉密集多点结扎,每隔2～3周重复治疗,直至曲张静脉全部根治。术后3、6、12个月定期随访及胃镜复查,术后3个月结果作为近期疗效判断依据,6个月以后作为远期疗效判断依据。结果126例患者共完成403次、3641点结扎,平均每例结扎3.2次、28.9点。急诊止血率为100.0％;近期食管静脉曲张根治率为94.4％、总有效率为100.0％、复发出血率为3.9％;经过平均22.3个月随访,远期食管静脉曲张复发率为11.9％、复发出血率为3.2％、未见复发出血死亡。术后多数患者有一过性门静脉高压性胃病加重。结论DEVL治疗能有效急诊止血、根治食管静脉曲张和预防再出血,远期疗效较好。治疗不受肝功能状态的影响,并发症少。
Objective To evaluate the short-term and long-term effects of dense endoscopic variceal ligation (DEVL) for bleeding esophageal varices. Methods Patients with acute or with a history of esophageal variceal bleeding underwent regular DEVLs with a 2-3 week interval between 2 sessions until their varices disappeared at the lower 5-6 cm part of the esophagus. Follow-up study and gastroscopy were performed at 3, 6 and 12 months after the final DEVL in all patients. The results at 3 months were classified as short-term effects and those after 6 months as long-term ones. Results 126 patients underwent DEVLs with 403 sessions and 3641 ligations; each patient was ligated with a mean of 3.2 sessions and at 28.9 points. The cure rate of acute variceal bleeding was 100.0%; short-term rate of variceal eradication was 94.4% and variceal rebleeding occurred in 3.9% patients. After a mean of 22.3 months follow-up period, the recurrence of esophageal varices was observed in 11.9% patients, but the variceal rebleeding rate was only 3.2% and no patients died from it. Conclusion DEVL was very useful and effective in both short-term and long-term variceal eradication and prevention of variceal rebleeding.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2005年第4期294-296,共3页
Chinese Journal of Hepatology
