组织黏合剂注射联合套扎治疗食管胃底静脉曲张破裂出血的临床观察

【目的】观察组织黏合剂注射联合套扎治疗食管胃底静脉曲张破裂出血的临床疗效及安全性。【方法】对32例食管胃底静脉曲张破裂出血患者进行内镜下治疗，胃底曲张静脉采用“三明治夹心法”行组织黏合剂注射，对合并的食管曲张静脉同时行套扎治疗。术后观察不良反应、并发症和近期疗效。【结果】组织黏合剂注射量1．0～3．5mL，平均1．8mL，套扎5～12点，平均8．2点。治疗成功率100％。6例出现胸痛（18．8％），2例出现上腹不适（6．3％），全组未有异位栓塞的发生，追踪3个月未有再出血病例，28例3个月后复查胃镜，见胃底曲张静脉消失或明显减轻，食管曲张静脉减轻与红色征消失。【结论】组织黏合剂注射联合套扎治疗食管胃底静脉曲张破裂出血安全、有效。

Clinical Observation of Tissue Adhesive Injection Combined Endoscopic Band Ligation for Bleeding Esophagogastric Varices

Objective] To observe the effect and safety of tissue adhesive injection combined endoscopic band ligation for bleeding esophagogastric varices. Methods]Thirty two patients with acute bleeding esophagogastric vari- ces received endoscopic treatment. Gastric fundus varices received tissue adhesive injection （using sandwich method） and esophageal varices received band ligation. Side effects, complications and efficacy in 3 months were observed. Results] The injection volume of tissue adhesive was 1.0-3.5 mL（mean 1.8mL）. The number of band ligation was 5-12 points （mean 8.2 points）. The success treatment rate was 100 %. Six cases （22.2%） of chest pain and two ca ses （6.3%） of upper abdominal discomfort occurred. The whole group had not occurred ectopie embolization and other complications. No rebleeding occurred in 3 month follow up. Twenty eight cases that received gastroscopy were found gastric fundus varices disappeared or significantly reduced,esophageal varices reduced and red color sign disap- peared after 3 months. Conclusion] The treatment of tissue adhesive injection combined endoscopic band ligation for bleeding esophagogastric varcies is effective and safe.