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目的探讨硬化剂与组织粘合剂联合注射治疗活动性食管胃静脉曲张大出血的急诊疗效,总结内镜下联合注射治疗的临床经验。方法回顾分析5例食管胃静脉曲张活动性大出血患者的急诊内镜下硬化剂联合组织粘合剂注射治疗的临床特点,对静脉曲张内镜下表现、联合治疗时机、治疗方法及疗效进行分析。结果内镜下经硬化剂与组织粘合剂联合注射治疗后均达到即刻止血效果,止血成功率100%。随访6~24个月,其中1例经再次治疗后随访至24个月未见出血;其余4例随访无再出血发生。结论硬化剂与组织粘合剂联合注射治疗活动性食管胃静脉曲张大出血是一种安全、有效的方法,其近期及远期疗效可靠,值得临床推广。
Objective To investigate the emergency curative effect of combination of sclerosing agent and tissue adhesive for the treatment of active esophageal and gastric variceal bleeding and to summarize the clinical experience of combined endoscopic injection therapy. Methods The clinical features of emergency endoscopic sclerotherapy combined with tissue adhesive injection in 5 patients with active esophageal variceal bleeding were retrospectively analyzed. Endoscopic findings of varices, timing of combination therapy, treatment and efficacy were analyzed. Results Endoscopic hemostatic effect was achieved immediately after sclerotherapy and tissue adhesive treatment, and the success rate of hemostasis was 100%. All cases were followed up for 6-24 months. One case was followed up for 24 months after re-treatment. No bleeding was found in the remaining 4 cases. Conclusion The combination of sclerosing agent and tissue adhesive for the treatment of active esophageal and gastric variceal bleeding is a safe and effective method, which has reliable curative effect in the short and long term and is worthy of clinical promotion.