食管静脉曲张内镜下治疗后预防和治疗反流性食管炎的意义

目的 :分析内镜套扎术和硬化剂注射后预防和治疗反流性食管炎的意义。方法 :本文随机比较了门静脉高压食管静脉曲张组和非门静脉高压组反流性食管炎发病的差异 ,比较内镜下套扎术和硬化剂注射后对食管黏膜的影响以及反流性食管炎对内镜治疗的影响。观察质子泵抑制剂和促动力药预防和治疗反流性食管炎及出血的重要性。结果 :门静脉高压食管静脉曲张者反流性食管炎的发病率高于非门静脉高压组 ,具有显著性差异。具有明显反流性食管炎的静脉曲张内镜下治疗后可加重反流性食管炎 ,并且再出血发生率亦高于无或有轻度反流性食管炎者。术中、术后常规给予质子泵抑制剂和促动力药可促进内镜治疗后黏膜愈合及预防出血的发生。结论 :门静脉高压易合并反流性食管炎 ,反流性食管炎是引起食管静脉曲张破裂出血的重要诱因 ,预防和治疗反流性食管炎可促进内镜下治疗后黏膜的愈合 ,并可预防术中术后出血。

SIGNIFICANCE OF PREVENTION AND TREATMENT OF REFLUX ESOPHAGITIS FOR THE PATIENTS WITH ESOPHAGEAL VARIX IN ENDOSCOPY

Objective:To analyze the significance of prevention and treatment of reflux esophagitis (RE) after ligation and sclerotherapy.Methods:The author compared the differences of incidence of RE in portal hypertension esophageal varix group and non-portal hypertension group randomly.Meanwhile studied the effect of ligation and sclerotherapy under endoscope on the esophageal mucosa and the effect of RE on the endoscopic therapy.Observed the importance of using proton-pump inhibitor (PPI) and gastro-intestinal prokinetic drug for treatment of RE and prevention of bleeding.Results:The incidence of RE in patients with portal hypertension esophageal varix was higher than that of non-portal hypertension group.It was significant difference.After the patients with serious RE were treated by the endoscopic therapy,their RE was exacerbated.And the rate of bleeding was higher than that of non-RE or mild-RE.PPI and gastro-intestinal prokinetic drug not only can effectively prevent and treat RE and promote healing mucosa after endoscopic therapy,but also can prevent the possibility of bleeding during and after operation.Conclusion:Portal hypertension complicated RE easily.RE ws the important factor which can cause bleeding due to esophageal varix.Prevention and treatment of RE can promote healing mucosa after endoscopic ligation and sclerotherapy and prevent bleeding during and after operation.