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食管静脉曲张破裂出血时,由于活动出血影响视野,采用硬化剂注射疗法在技术上有一定困难。三腔气囊管压迫或使用血管收缩剂虽可止血,但48小时以内的再出血率在60%以上。作者的治疗方针是用三腔气囊管压迫止血后,在12小时内注射硬化剂以防止再出血,并试图在长时期内保持稳定。硬化剂的注射部位虽有静脉腔内或静脉周围之分,但在实际操作时很难截然分开,而效果亦无不同。由于出血部位80%在胃食管交界1～2cm 的范围内,多数医生在此处注射硬化剂,如果只在贲门部位注射,常无效。
Esophageal variceal bleeding, due to the impact of bleeding from the field of vision, the use of sclerotherapy is technically difficult. Three-chamber balloon catheter compression or use of vasoconstrictor although hemostasis, but within 48 hours of rebleeding rate of 60% or more. The author’s treatment guidelines are three-chamber balloon compression hemostasis, injection of sclerosant within 12 hours to prevent rebleeding, and try to remain stable over a long period of time. Although the injection site hardener venous cavity or vein around the points, but in practice it is difficult to completely separate, but the effect is no different. Because 80% of bleeding site in the gastroesophageal junction of 1 ~ 2cm range, most doctors here injection of sclerotherapy, if only in the cardia injection, often ineffective.