三腔二囊管插入及固定方法的改良

目的：探讨改良三腔二囊管在抢救食管胃底静脉曲张破裂大出血中的临床应用价值。方法：将113例食管胃底静脉曲张破裂大出血患者随机分为传统组（55例）和改良组（58例）。传统组常规方法插入三腔二囊管后用500g重物悬吊牵引固定；改良组采用沙氏导丝法插入三腔二囊管后，用改良乒乓球法固定。比较两组一次插管成功率、止血效果及并发症发生率。结果：改良组一次插管成功率（100％）高于传统组（81．8％），差异有统计学意义（P〈0．05）；两组止血成功率分别为90．9％和93．1％，差异无统计学意义（P〉0．05）；改良组并发症发生率较传统组低，胸闷胸痛程度较传统组减轻，差异有统计学意义（P〈0．05）。结论：改良三腔二囊管具有一次插管成功率高，止血效果确切，并发症少，患者耐受性好，简单易行的优点，值得推广。

Modified sengstaken blakemore tube in the treatment of esophagogastric varices bleeding

Objective： To investigate the effects of Modified Sengstaken-Blakemore tube in the treatment of esophagogastric varices bleeding （EVB）. Method：113 patients with EVB were randomly divided into the improved group （58 patients） and the control group （55 patients）. Modified Sengstaken-Blakemore tube inserted by wire and fixed by pingpong was performed on patients in improved group. Sengstaken-Blakemore tube inserted and fixed by conventional method was performed on patients of control group. The one-time success rate of insertion,the hemo-static effect and the incidence of complications of the two groups were compared. Result：The hemostatic effect were satisfactory in both groups, and there was no significant difference between them. The one-time success rate of in-sertion in the improved group （100%） was higher than that of the control group （81.8%）（P〈0.05）. The inci-dence of complications in the improved group was lower than that of the control group （P〈0.05）. Conclusion： Modified Sengstaken-Blakemore tube inserted by wire and fixed by pingpong is a relatively safe and effective meth-od for patients with EVB.