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读者对拙作所提出的宝贵意见表示谢意.至于食道静脉曲张破裂出血应用垂体后叶素达到止血目的之后,有无必要待续使用7——10天,以及使用的必要性怎样?是值得今后共同研究观察以予证明. 读者根据??氏的血栓机化在2——3天即已开始,3——4天已有来自管壁的结缔组织和微血管浸入血栓而紧密地结合在一起,因此指出垂体后叶素就完全没有必要继续使用.我们认为,这种血栓机化演变过程仅符合于一般破损组织而言,而对食道静脉曲张破裂患者,因静脉压力高,随时有冲破血栓的可能,似不能完全套用一般血栓形成演变规律.至于读者所指出的组织供血减少,影响组织代谢,对肝、脑影响,促成腹水形成等等.如同众所周知,肝硬化并发食道下端静脉曲张破裂出血之患者,在紧急大量出血情况下是分秒必争,随时有死亡的危险(即使已经初次得到止血),故应当机立断.显然的,即使没有当场死亡,就大量出血这一点对组织缺氧,肝、脑的损害,腹水形成的严重后果也是不言而喻的.
The reader is grateful for my valuable comments.As for the esophageal variceal bleeding application of vasopressin to achieve the purpose of hemostasis, the need for continued use of 7 - 10 days, and the need for use is worth the future common Research and observation to prove that the reader according to ?? thrombosis machine has begun in 2--3 days, 3 - 4 days have been from the wall of the connective tissue and microvascular infiltration thrombus closely together, so Pointed out that vasopressin is completely unnecessary to continue to use.We believe that this evolution of thrombosis is only in line with the general damage to the organization, and for patients with esophageal varices, due to high venous pressure, at any time may break the thrombus , Can not seem to fully apply the general rule of thrombosis evolve as the reader pointed out that the organization to reduce blood supply, affecting tissue metabolism, liver and brain effects, resulting in the formation of ascites, etc. As we all know, cirrhosis of the lower esophageal variceal bleeding patients , In the case of an emergency a large number of bleeding is second to none, danger of death at any time (even if he had been the first to stop bleeding), it should be decisive. Even without died on the spot, on this point of heavy bleeding tissue hypoxia, liver and brain damage, serious consequences ascites formation is self-evident.