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目的:食管静脉曲张破裂出血是肝硬化患者的主要合并症,也是肝硬化最主要的死亡原因。本研究旨在对内镜下套扎治疗食道曲张静脉的方法进行初步的前瞻性研究,探讨其对食管静脉曲张破裂出血的治疗价值。方法:常规行胃镜检查,记录食管静脉曲张的情况。并明确有无胃底静脉曲张,自胃食管粘膜连接处(齿状线)开始行密集式结扎治疗,每根曲张静脉的相临结扎点距离约3cm左右,自下而上呈螺旋式上升,直至所有曲张静脉均被结扎为止。结果:食道静脉套扎术可以明显地缓解静脉曲张程度,两周后复查结扎一次曲张静脉全部消除率为28%(12/43)。结扎2次者全部消失的有8例,结扎3次曲张静脉全部消除的有1例。静脉全部消失率为46%(20/43)。结论:Binmoeller等认为EVL是治疗食管静脉曲张破裂出血的首选方法[2]。使用连续套扎治疗可以明显地减轻静脉曲张的程度。而且操作简便,效果较好,操作迅速、患者痛苦小,术间、术后一般无明显并发症,是较为理想的治疗方法。
Objective: Esophageal variceal bleeding is the main complication of patients with cirrhosis, but also the most important cause of death of liver cirrhosis. The purpose of this study is to prospectively study the method of endoscopic ligation of esophageal varicose veins to explore the therapeutic value of esophageal variceal bleeding. Methods: routine endoscopy, recording esophageal varices. And clear whether there is gastric varices, since the junction of the gastroesophageal mucosa (dentate line) began intensive ligation of the line, each varicose vein adjacent ligation point distance of about 3cm, a spiral upward from the bottom up, Until all varicose veins have been ligation so far. Results: Esophageal vein ligation could relieve varicose veins significantly. After two weeks, the total elimination rate of varicose veins was 28% (12/43). There were 8 cases in which ligation of the second ligation disappeared, and 1 case of ligation of the varicose veins in 3 times. Vein disappearance rate was 46% (20/43). Conclusion: Binmoeller et al. [2] considered EVL the preferred method for the treatment of esophageal variceal bleeding [2]. The use of continuous ligation treatment can significantly reduce the extent of varicose veins. And the operation is simple, the effect is better, the operation is rapid, the patient is little pain, and there is no obvious complication after operation, which is an ideal treatment method.