摘要
目的研究内镜下注射组织粘合剂治疗胃静脉曲张出血时组织粘合剂的用量和排胶规律,评价该治疗方法的远期疗效和安全性。方法在1年半时间内148例活动性(25例)或近期(123例)胃静脉曲张出血的患者行内镜下组织粘合剂注射治疗直到曲张静脉闭塞。根据上腹部平片、CT血管成像和电子胃镜观察排胶规律。平均随访时间为13.1个月。结果86.1%患者在1个月内排胶,在1年内可消失。内镜下组织粘合剂注射后团块形态与血管解剖结构相近,排胶时间与剂量无关系。远期生存率的决定因素是引起门脉高压的基础疾病。主要并发症是排胶出血,严重并发症是异位栓塞。结论内镜下注射组织粘合剂是治疗胃静脉曲张出血的一种安全有效的治疗方法,适合作为胃静脉曲张出血的首选治疗方法。
[ Objective ] To study the extrusion rule of glue after endoscopic N-butyl-2-cyanoacrylate injection on gastric variceal bleeding and evaluate the long-term efficacy and safety. [Methods] 148 patients of liver cirrhosis with EGV at our hospital from June 2007 to December 2008 subjected to the injection. The information of each pa- tients＂ gender, age, complications, stage of gastric varices, number of treatment, dosage of eyanoacrylate agent, out- come of GV, diameter of main portal tract, liver function, blood routine tests were collected. We analyzed the extru- sion rule of glue by abdominal X-ray and endoscopy. We described data with mean -＋ standard deviation （x-＋S）, me- dian （Md）. The average follow-up time was 13.1 months. [Results] The cast of glue of 86.1% patients is extruded into the lumen within one month and eliminated within one year, generally without resultant bleeding. The obliterate rate is 70.2% （104 cases） by endoscopic check. The glue clumping shape is correlated with anatomic structure of vessel. The time of extrusion isn＇t relative with dosage of glue. The main complication is re-bleeding resulting from extrusion. The determinative factor of long-term survival rate is the basic disease which cause portal hypertension. [ Conclusion ] Endoscopic injection of cyanoacrylate is highly effective for the treatment of bleeding gastric varices, with rare complications both acutely and long term.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第1期9-13,共5页
China Journal of Endoscopy
关键词
胃静脉曲张出血
组织粘合剂
门脉高压
排胶
gastric variceal bleeding
N-butyl-2-cyanoacrylate
portal hypertension
glue extruded
