套扎治疗对预防肝硬化食管静脉曲张破裂出血的临床评价

目的 探讨肝硬化食管静脉曲张破裂出血有效预防性治疗方法.方法 选择肝硬化因食管静脉曲张破裂出血经急诊内镜下硬化剂(1％聚桂醇)治疗出血停止后患者45例,分为愿意接受套扎治疗23例(治疗组)和不愿意接受套扎治疗22例(对照组),按肝功能child-pugh分级A、B、C分别观察疗效(本组资料仅有B级、C级的患者).结果 治疗组1年内B级患者无1例发生食管静脉曲张破裂出血,C级患者则有2例发生食管静脉曲张破裂出血并死亡1例；2年内B级患者有2例发生食管静脉曲张破裂出血,C级患者则有4例发生食管静脉曲张破裂并死亡2例.对照组1年内B级患者发生食管静脉曲张破裂出血6例死亡2例,C级患者发生食管静脉曲张破裂出血10例次,死亡4例；2年内B级患者有8例发生食管静脉曲张破裂出血,死亡仍是2例,C级患者发生食管静脉曲张破裂出血者12例次,死亡6例.结论 套扎治疗最大限度地预防肝硬化食管静脉破裂再出血或延缓了再次出血的时间,是治疗肝硬化食管静脉曲张破裂出血的安全、可靠、有效的方法.

Variceal ligation in prevention of esophageal varices bleeding:A clinical evaluation

Objective To explore an effective therapy in the prevention of esophageal varices bleeding of liver cirrhosis. Methods 45 cases of cirrhosis of liver were chosen who had suffered from esophageal varices bleeding and the bleeding was stopped after the treatment of emergency endoscopic sclerotherapy. The cases were divided into a treatment group （ 23 cases ） and a control group （ 22 cases）. Therapeutic effect was observed according to A, B and C grades of liver function Child-pugh scales. Results As for the treatment group within one year, no case of esophageal varices bleeding occurred among grade B patients, but 2 cases occurred among grade C patients and one case of death. Within a span of 2 years, 2 cases of esophageal varices bleeding occurred among grade B patients, and 4 cases in grade C patients and 2 cases of death. In terms of the control group,in contrast,6 cases of esophageal varices bleeding developed among grade B patients within one year and 2 cases of death occurred. But 10 cases of esophageal varices bleeding occurred in grade C patients and 4 cases of death. In a two yearsI span, there were 8 grade B cases of esophageal varices bleeding and 2 cases of death. But among grade C patients, the number of patients who developed esophageal varices bleeding was 12 and the case of death was 6. Conclusion Variceal ligation can to the most extent prevent the occurrence of esophageal varices bleeding, or postpone the happening of hemorrhage. It is safe, reliable and effective for the treatment of esophageal varices bleeding of liver cirrhosis.