摘要
目的探讨急诊胃镜注射组织胶治疗肝硬化合并胃底静脉曲张破裂出血的疗效。方法选取2010年9月至2012年3月由北京军区总医院肝病治疗中心收治的57例肝硬化合并胃底静脉曲张破裂出血患者作为研究对象,所有患者均在出血后24 h内接受胃镜下注射组织胶治疗。57例患者共接受76点组织胶注射,累计注射组织胶109 mL。结果①76点组织胶注射均取得成功,成功率为100%。②57例患者均为活动性出血,注射组织胶后均即时止血,随访期间未发现再出血病例。24例患者复查了胃镜,10例患者胃底曲张静脉明显缩小,14例患者胃底曲张静脉未见明显变化。近期死亡3例,病死率为5.3%,死亡原因均为肝性脑病。③所有患者术后均未出现明显不良反应,14例患者出现低热,9例患者出现上腹饱胀不适感。结论急诊胃镜注射组织胶治疗肝硬化合并胃底静脉曲张破裂出血的疗效确切,具有止血效果好、止血速度快、再出血发生率低、不良反应较轻等优点。
Objective To investigate the therapeutic efficacy of endoscopic injection of tissue glue in the emergency treatment of liver cirrhosis complicated by gastric variceal bleeding. Methods During Sep. 2010 and Mar. 2012,57 cases of liver cirrhosis complicated by gastric variceal bleeding admitted to Center of Liver Disease Treatment of Beijing Military Region General Hospital were selected as the objects of study,and all patients were given endoscopic injection of tissue glue in 24 hours after bleeding. 76 points received tissue glue injection in all 57 cases of patient,and 109 mL of tissue glue was used. Results ①All points got success in tissue glue injection,and the success rate was 100%. ②It was diagnosed as active bleeding in all 57 cases,and the bleeding immediately stopped after tissue glue injection,and no rebleeding case was found during the follow-up period. 24 cases of patient patients received re-examination of endoscopy,and the gastric varices shrank in 10 cases,while there was no obvious change in other 14 cases. There were 3 cases of patient who died from hepatic encephalopathy recently,and the mortality rate was 5. 3%. ③There were no obvious adverse reactions in all 57 cases of patient,and 14 cases had low-grade fever,while 9 cases had bloating discomfort. Conclusion The endoscopic injection of tissue glue shows good therapeutic efficacy in the treatment of liver cirrhosis complicated by gastric variceal bleeding,and this treatment program is of good hemostatic effect,high hemostatic velocity,low incidence of rebleeding,light adverse reactions and so on.
出处
《医学综述》
2013年第24期4555-4556,共2页
Medical Recapitulate
关键词
胃镜
组织胶
肝硬化
胃底静脉曲张破裂出血
Gastroscopy
Tissue glue
Liver cirrhosis
Gastric variceal bleeding
