摘要
目的评价内镜食管静脉结扎法治疗食管静脉曲张出血远期疗效。方法采用内镜食管静脉结扎法治疗263例食管静脉曲张出血病人,每隔2周重复结扎治疗,直至曲张静脉完全闭塞。结果 238例生存期超过3个月的病人中有216例(91%)曲张静脉被根治,曲张静脉的根治需平均结扎治疗4次。全组1、3、5年累积生存率分别是76%、62%、57%。生存率主要取决于肝功能状况。死亡56例(21%),主要死因是肝功能衰竭。再出血主要发生在治疗早期,曲张静脉根治后再出血明显减少。再出血率为155(39/263)。结论内镜食管静脉结扎法是治疗食管静脉曲张出血安全有效的方法;重复该法治疗多数情况下可根治曲张静脉,降低再出血率;坚持内镜食管静脉结扎法治疗可减少再出血导致的死亡,延长曲张静脉出血病人的生存期。
Objective This study aimed at assessing the long-term efficacy of EVL for esophageal variceal bleeding. Methods Long-term EVL was assessed in 263 patients with variceal bleeding,among them 71 were of Child- Pugh Class A,82 of Class B and 110 of Class C.EVL was repeated at two week intervals until varices were eradicated.Results Esophageal varices were eradicated in 91% of the 238 patients who survived for more than three months after 1 to 10 (average 4) successive ligations.Recurrent variceal bleeding occurred in 15% of the 263 patients and was markedly reduced after eradication of the varices.The overall cumulative survival rates at 1,3,and 5 years were 76%,62%,and 57%,respectively.The prognosis was influenced by Child- Pugh's risk grade.56 of the 263 patients died during the study period,and the major cause of death was liver failure.Conclusion EVL is effective for long-term control of esophageal variceal bleeding.Repeated EVL re- duces rebleeding rate and improves survival in patients who have bled from esophageal varices.
出处
《中华普通外科杂志》
CSCD
1998年第2期86-87,共2页
Chinese Journal of General Surgery
关键词
门静脉高血压
食管胃静脉曲张
止血
内窥镜
Hypertension,portal
Esophageal and gastric varices
Hemostasis,endoscopic
