内镜联合胃底静脉栓塞治疗胃底贲门口静脉曲张大出血

目的：食管静脉曲张破裂出血是肝硬化患者常见的死亡原因，少数患者出血量大，经药物和三腔管压迫无法控制，内镜治疗后仍有再出血的危险性，本文介绍了治疗贲门口胃底转折处曲张静脉破裂大出血的方法。方法：2例因贲门口胃底转折处曲张静脉破裂大出血的患者，经生长抑素、三腔管压迫及对症支持治疗后出血量仍然很大，生命体征不平稳，予紧急内镜下硬化剂治疗，待生命体征平稳后行胃底静脉栓塞术。结果：2例患者经上述方法治疗后出血停止，随访2－5个月未再继续出血。结论：内镜下硬化剂治疗联合胃底静脉栓塞术是治疗贲门口胃体胃底转折处曲张静脉破裂大出血的有效方法。

Endoscopic Sclerotherapy Combined with Embolization of Gastric Fundal Varices inthe Management of Heavy Bleeding from Varices of Cardia and Gastric Fundus

Objective: Esophageal variceal bleeding is the common death cause of cirrhotic patients. Among them, some patients with large amount blood loss may face the re - bleeding risk after conventional drug therapies, balloon tamponade tube or endoscopic therapies. This paper introduces the treatment method for the heavy bleeding from the varices in the curve area between the cardiac and gastric fundus. Methods: Two cirrhotic patients suffering from the variceal bleeding in the curve area between the cardiac and fundus kept on large amount of hemorrhage after somatostatin, balloon tamponade tube and other conventional supportive therapies. The emergent endoscopic sclerotherapy was conducted during their unstable vital status. Then gastric fundal varices embolization was performed. Results: The heavy bleeding of these 2 patients stopped and there was no re -bleeding in the 2 - 5 months follow-up. Conclusion: The gastric fundal varices embolization combined with the endoscopic sclerotherapy is an effective method for controlling the heavy bleeding from the varices in the curve area between the cardiac and gastric fundus.