食管静脉曲张硬化疗法的长期疗效观察

对５４２例肝硬化并发食管静脉曲张患者行硬化剂治疗，随访１～７年，平均为３．９年。按所用硬化剂不同分四组：（１）５％鱼肝油酸钠８１例；（２）纯酒精６７例；（３）混合剂（鱼肝油酸钠加纯酒精）２０９例；（４）混合剂加服汉防己甲素１８５例。结果：急性出血止血率９５．５％，曲张静脉消失率１２１例（２２．３％），完全消失仅２２例。止血效果四组间无差异。静脉曲张消失以３、４组为高（Ｐ＜０．０５）。失访２３例，改外科治疗７０例。累计再出血率为１４．７％，死亡９５例，占随访４４９例２１．１％。直接死于再发出血３４例。随访期生存例数３５４例（７８．８％）。本文提示硬化剂治疗食管静脉曲张急性出血止血率高，但曲张静脉消失率仍低，若加服汉防己甲素并结合外科治疗能提高病人生存率。

LONG TERM FOLLOW UP OF SCLEROTHERAPY FOR ESOPHAGEAL VARICES

We had done sclerotherapy for 542 cirrhotic patients with esophageal varices.Follow-up time was 1 month to 7 years(average time 3.9 years).We divided the patients into four groups according to the sclerotic reagents:(1) morrhuate sodium treatment 81 cases,(2)absolute alcohol treatment 67 cases,(3)combined reagents treatment(alcohol and morrhuate sodium)209 cases,and(4) combined reagents and tetrandrine treatment 185 cases. Acute hemorrhage stopping rate was 95.5%. There was no significant difference between the four groups.Variceal disappearance rate was 22.3%,and that of 3 and 4 groups were higher(P<0.05),only 22 cases of varices were cured.Recurrent hemorrhage rate was 14.7%.70 cases was operated.General mortality was 21.1%.34 cases died of hemorrhage.It's suggested that,sclerotherapy has an effect on stopping acute variceal haemorrhage,but varices can not be disappeared and if patients get sclerotherapy operation and combined tetrandrine treatment,survival rate can be increased.