内镜下套扎术预防晚期血吸虫病食管静脉曲张破裂出血

目的 目的 探讨内镜下套扎术预防晚期血吸虫病 （晚血） 食管静脉曲张再发和破裂出血的作用。方法 方法 治疗组为42例套扎术后晚血患者， 对照组为同期住院不愿接受套扎治疗的30例晚血患者， 治疗期间3～6个月复查胃镜1次， 了解食管静脉曲张情况， 并记录有关医疗事件。 结果 结果 套扎治疗后随访2～3年， 平均29个月。治疗组静脉曲张复发8例， 复发率19.0%， 平均复发时间30个月； 发生食管静脉曲张破裂出血5例， 发生率11.9%， 平均发生时间25个月， 死亡2例。对照组静脉曲张复发13例， 复发率43.3%， 平均复发时间18个月， 发生出血11例， 发生率36.7%， 平均发生时间18个月， 死亡7例。治疗组在预防食管静脉曲张破裂出血， 降低病死率方面优于对照组。结论 结论 套扎术可作为预防晚血食管静脉曲张破裂出血的方法。

Endoscopic variceal ligation in prevention from esophageal variceal hemorrhage of advanced schistosomiasis patients

Objective To evaluate the effect of the endoscopic esophageal variceal ligation on the prevention from recurrence of esophageal varices and variceal hemorrhage. Methods Forty?two advanced schistosomiasis patients with variceal hemorrhage in the treatment group received the endoscopic esophageal variceal ligation，and 30 patients in the control group did not，and all of them had oral propranolol，spironolactone and 5 single?isosorbide dinitrate etc. in hospital for the same period and had these drugs for 3?6 months after discharge. The re?examinations of endoscopy were performed once 3 to 6 months. Results The time of follow? up was from 2 to 3 years and the average was 29 months. In the treatment group，the rate of recurrence of esophageal varices was 19.0%（8/42）and the average time was 30 months；the incidence of esophageal variceal bleeding was 11.9%（5/42）and 2 pa? tients died. In the control group，the rate of recurrence of esophageal varices was 43.3%（13 /30）and the average time was 18 months；the incidence of esophageal variceal bleeding was 36.7%（11/30）and 7 patients died. The therapeutic efficacy of the treatment group was much superior to that of the control group. Conclusion The endoscopic esophageal variceal ligation is effec? tive and safe， and can become one of the preferred methods in the prevention from variceal hemorrhage.