共查询到20条相似文献,搜索用时 46 毫秒
1.
2.
食管静脉曲张破裂出血硬化治疗的疗效观察 总被引:3,自引:0,他引:3
我院自1991年8月至1996年10月对54例食管静脉曲张破裂出血的患者,经内镜采用少点、大剂量、快速静脉内注射5%鱼肝油酸钠的硬化治疗方法,取得了较好的效果,并与42例药物治疗的疗效作了对比。 相似文献
3.
张正坤 《现代消化病及内镜杂志》1997,2(3):256-256,235
我院自1991年8月-1996年10月对54例食管静脉曲张破裂出血的患者,经内镜采用少点、大剂量、滞针法静脉注射5%鱼肝油酸钠的治疗方法,取得了良好效果,并与42例药物治疗的疗效作了对比,现总结报告如下。 相似文献
4.
食管胃底静脉曲张破裂大出血是门脉高压主要并发症之一,病死率较高。这些患者在急性出血时常伴有失血性休克和严重的凝血功能障碍,使外科手术受到限制。我科采用生长抑素治疗食管胃底静脉曲张破裂出血40例,疗效显著,现报道如下。(一)材料与方法1.病例选择:本组病例系1995~1998年住院的肝硬化门脉高压食管胃底静脉曲张破裂出血患者78例,诊断符合1995年5月北京第五次全国传染病和寄生虫病学术会议修订的标准,并经胃镜检查证实。其中有肝炎、肝硬化史者46例,有出血史者24例。男性62例,女性16例;年龄2… 相似文献
5.
目的评价5%鱼肝油酸钠内镜下静脉注射法进行紧急硬化治疗对食管胃底静脉曲张破裂出血的疗效。方法对18例食管胃底静脉曲张破裂出血住院患者,用5%鱼肝油酸钠,行镜下曲张静脉内注射,观察止血效果、副作用和并发症。结果17例成功止血,止血成功率为94.4%。全部病例均有短期可忍受的胸骨后疼痛,1例呼吸骤停(经抢救治愈)。结论5%鱼肝油酸钠内镜下静脉内注射法紧急硬化治疗是食管胃底静脉曲张破裂出血的一种有效、方便和比较安全的止血方法。 相似文献
6.
食管静脉曲张出血的硬化治疗 总被引:3,自引:0,他引:3
我院自1994年以来,对128例食管静脉曲张破裂出血患者采用硬化止血治疗,取得满意疗效。 1.一般资料:本组128例均为我院住院患者,在入院后12~24 h内完成第1次急诊止血治疗。年龄19~73岁,平均49岁。随机分为两组。对照组(单用5%鱼肝油酸钠)68 相似文献
7.
食管胃底静脉曲张出血的治疗 总被引:5,自引:0,他引:5
食管胃底静脉曲张破裂出血是门静脉高压主要的并发症,常引起出血性休克或诱发肝性脑病,如不及时采取有效措施,可导致患者死亡。食管胃底静脉曲张出血的内科治疗程序如下。 1.基础治疗:补充血容量,纠正酸碱失衡。(1)大出血病人应立即进行的是恢复血容量治疗而不是急诊内镜检查,进行快速补液,常用的是平衡液或糖盐水。抢救的开始阶段,应强调的是输液速度而不是液体的质。当中心静脉压<0.49kPa(5cmH2O)时可加速补液,>1.47kPa(15cmH2O)时说明补液过多,应停止输液。一旦休克纠正,就应重视补液… 相似文献
8.
食管胃底静脉曲张破裂出血是肝硬化门静脉高压症的严重并发症,由于多数患者伴有严重肝功能损害,死亡率和再出血率高。近年来,人们已找到许多方法有效地预防和治疗急性静脉曲张破裂出血,内镜多环套扎术(EndoscopicMultiple Ligation,EML)和内镜下食管静脉曲张硬化术(En-doseopic Variceal Sclerotheraphy,EVS)便是其中两种。1997年9月以来,我们采用EML加EVS治疗食管胃底静脉曲张,并尝试对无出血史者行预防性治疗,取得较好效果。 相似文献
9.
230例食管胃静脉曲张出血患者急诊硬化治疗 总被引:31,自引:2,他引:31
总结230例食管胃静脉曲张出血患者283次急诊硬化治疗(EIS)的经验。230例出血患者于出血后24小时内行283次EIS,采用5%鱼肝油酸钠或1%乙氧硬化醇,食管胃静脉内注射法。283例次中活动性出血253例次,30例次出血已停止,首次EIS能明确出血部位共142例次,为63%(128/253)。急诊止血率为96.4%,并发症20例,发生率8.6%,EIS并发症引起的死亡4例,死亡率为1.7%。EIS是食管胃静脉曲张出血的一种有效治疗方法,适应证宽,方法简便、安全。 相似文献
10.
食管、胃底静脉曲张出血的治疗济南军区总医院(250031)于峻基食管、胃底静脉曲张急性出血是肝梗化严重的并发症之一,首先采用内科治疗,无效时可行介入或手术治疗。对预防出血应予综合治疗。1急性出血的治疗内科治疗:①三腔管填压仍为有效方法,应强调熟练操作... 相似文献
11.
Mitsunobu Matsushita Yoshiya Tahashi Kazushige Uchida Akiyoshi Nishio Hiroshi Takakuwa Kazuichi Okazaki 《Digestive endoscopy》2009,21(2):131-133
Although a purple‐colored ball‐like appearance (purple ball appearance) is typically observed on ligated varices during endoscopic variceal ligation (EVL), another endoscopic appearance of ligated varices (white ball appearance), which is observed after EVL at the bleeding site, have been reported. We encountered a case of massive variceal bleeding with an obscure bleeding point, where this appearance was useful in the confirmation of effective ligation. A 66‐year‐old man, who had liver cirrhosis with hepatocellular carcinoma, presented with hematemesis and melena. Although emergent endoscopy revealed a fibrin‐plug on the esophageal varix, massive esophageal bleeding occurred and precluded direct visualization of the bleeding point during endoscopy. After multiple EVL, one ball‐like elevation with a white color (white ball appearance) and multiple ball‐like elevations with a red or purple color (purple ball appearance) were observed in the esophagus. Based on the presence of the white ball appearance, a predictor of effective ligation, we confirmed the ligation of the exact site of bleeding and complete cessation of bleeding. In fact, the ligated varix with the white ball appearance contained a ruptured point. This characteristic endoscopic appearance is useful for the assessment of effective ligation in massive variceal bleeding with an obscure bleeding point. 相似文献
12.
Mikinori Kataoka Takashi Kawai Kenji Yagi Chizuko Tachibana Hiroyuki Tachibana Hiroko Sugimoto Yasutaka Hayama Kei Yamamoto Masaya Nonaka Takaya Aoki Toshihiro Oshima Mari Fujiwara Mari Fukuzawa Masakatsu Fukuzawa Kouhei Kawakami Yoshihiro Sakai Fuminori Moriyasu 《Digestive endoscopy》2010,22(2):151-155
The present study was designed to evaluate the usefulness and safety of bipolar hemostatic forceps, known as a less invasive and highly safe means of thermal coagulation used for hemostasis in cases of non‐variceal upper gastrointestinal bleeding. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis. The study involved 39 cases where hemostasis was attempted with bipolar forceps to deal with non‐variceal upper gastrointestinal bleeding, including 28 cases of gastric ulcer, six cases of duodenal ulcer, three cases of bleeding after endoscopic submucosal dissection (ESD), one case of Mallory‐Weiss syndrome and one case of postoperative bleeding from the anastomosed area. There were 34 males and five females, with a mean age of 63.6 years. Bipolar forceps were the first‐line means of hemostasis in cases of oozing bleeding (venous bleeding), pulsatile or spurting bleeding (arterial bleeding) and exposed vessels without active bleeding. The primary hemostasis success rate was 92.3%, and the re‐bleeding rate was 0%. In cases where the bleeding site was located along the tangential line or in cases where large respiration‐caused motions hampered identification of the bleeding site, hemostasis by means of coagulation was easily effected by application of electricity while the forceps were kept open and compressed the bleeding area. In addition, there were no complications. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis. 相似文献
13.
施他宁对食管胃底静脉曲张破裂出血的疗效 总被引:1,自引:0,他引:1
目的 探讨施他宁对食管胃底静脉曲张破裂出血(EVB)的疗效。方法 142例EVB患者随机分为两组:施他宁(SS)组72例,先以250μg静注,随后以250μg·h~(-1)持续静滴共3d;对照组70例,用垂体后叶素20单位加入5%葡萄糖,以0.2u·min~(-1)静滴,1次/8h,共3d。结果 SS组3d天内的止血率明显优于对照组(P<0.01),再出血率(P<0.05)、病死率(P<0.01)及副作用发生率(P<0.01)明显低于对照组。结论 SS是治疗EVB的安全有效药物。 相似文献
14.
目的 评价内镜套钆治疗肝硬化门脉高压食管静脉曲张出血的远期效果。方法 内镜低位密集套扎,首次套扎6-12点,后隔2周重复套扎直至食管静脉曲张完全闭塞和缩小至I度以下。追踪时间,第1次于治后3个月,第2交于治后6-12个月,以后每年1次。追踪发现复发者动员再次套扎。结果 21例中套扎1次3例,2次10例,3次8例。近期止血效果好。随访1-3年,再出血8例,死于再出血4例。死亡病例中肝功能按Child's分级属C级为主。结论 套扎治疗食管静脉曲张出血远期疗效,以反复多次套扎使食管静脉曲张呈根治状态的病例效果好,出血复发率亦低。远期存活率与肝功能损害程度有关。 相似文献
15.
目的 探讨抗生素对奥曲肽治疗食管曲张静脉破裂出血(EVB)的影响。方法 60例EVB患者,随机分为2组,分别给予奥曲肽、奥曲肽联合抗生素治疗。结果 EVB患者6小时、12小时、24小时止血率奥曲肽组分别为27%、40%、63%。治疗前后血清一氧化氮(NO)含量分别为6.9±0.82μmol/L、5.6±0.95μmol/L;奥曲肽联合抗生素组止血率分别为50%、70%(P<0.05)、93%(P<0.05)。治疗前后NO含量分别为7.3±0.66μmol/L、4.3±0.79μmol/L(P<0.05)。结论 抗生素能明显提高奥曲肽治疗EVB的疗效,其机理可能与降低血清NO含量有关。 相似文献
16.
食管静脉曲张密集结扎术和硬化及结扎联合术的疗效对照观察 总被引:18,自引:1,他引:18
比较内镜下食管静脉曲张密集结扎术和内镜下硬化及结扎联合术治疗食管静脉曲张破裂出血的疗效。42例食管静脉曲张破裂出血病情稳定的病人分为两组,22例患者接受DEVL,20例病人行ES+EVL,两组具有可比性(P>0.05)。第1次治疗,DEVL组每个病人平均结扎11.32个点,每根曲张静脉平均结扎2.83个点;ES+EVL组首先静脉内注射硬化剂,然后行结扎,第1次治疗平均每根曲张静脉注射硬化剂1.03次(点),结扎1.01个点。结果:第1次治疗后,DEVL组食管静脉曲张消失率为50%,ES+EVL组为35%,两组比较无统计学意义(P>0.05);第1、4、12及24周的再出血率,DEVL组为4.5%、4.5%、4.5%、4.5%,ES+EVL组为10%、15%、15%、25%,两组无显著差别(P>0.05)。DEVL和ES+EVL均为治疗食管静脉曲张破裂出血、根除食管静脉曲张的有效方法,DEVL的操作较容易、并发症较少、再出血率较低,内镜下食管静脉曲张密集结扎术将取代内镜下硬化剂注射疗法,成为治疗食管静脉曲张破裂出血的首选方法。 相似文献
17.
Masaichi Ohira Kazuhiko Yoshikawa Takeshi Hori Sadatoshi Shimizu Yoshito Yamashita Nobuya Yamada Tetsuji Sawada Hiroji Nishino Michio Sowa Kosei Hirakawa 《Digestive endoscopy》2000,12(2):147-154
Background : We investigated the factors influencing esophageal variceal recurrence after endoscopic treatment on the basis of 25 variceal patients who were measured for esophageal variceal pressure, which had been reported to have a close relationship to variceal rupture. Method : Six patients (24.0%) showed variceal recurrence during follow‐up periods of up to 60 months. Clinical, biochemical, endoscopic and portal hemodynamic parameters were analyzed by univariate analysis in order to determine variceal recurrence. Results : The cumulative risk of variceal recurrence was greater in patients with F3 varices (P = 0.027), and esophageal variceal pressure (EVP) ≥ 15 mmHg (P = 0.021). It was not significantly related to any clinical, biochemical parameter. Large portosystemic collaterals, which were not concerned with esophageal varices, were demonstrated in five patients who had never showed variceal recurrence; all of their EVP were under 15 mmHg. Conclusion : It is suggested that the form of varices and EVP, which may reflect a part of portal hemodynamics, are the most reliable factors for predicting variceal recurrence. 相似文献
18.
19.
食道曲张静脉套扎术对肝硬化患者门静脉血流动力学的影响 总被引:9,自引:0,他引:9
目的:了解食道曲张静脉套扎术(EVL)后门静脉血流动力学改变与临床的关系。方法:采用彩色多普勒对25例肝硬化患者内镜下EVL前后的门静脉血流动力学改变进行测定。结果:EVL治疗2周后肝硬化患者门静脉、脾静脉内径(PD、SD)、门静脉血流速度及血流量(PV、PQ.SQ)较治疗前明显增加(P值<0.01),脾静脉血流速度(SV)明显减慢(P值<0.01)。结论:EVL能短时间升高门静脉压,部分地加重PHG和LF。 相似文献
20.