现代仪器与医疗
現代儀器與醫療
현대의기여의료
Modern Instrument and Medical Treatment
2014年
4期
40-43
,共4页
肝硬化%食管为敌静脉曲张%腹外疝%内镜治疗
肝硬化%食管為敵靜脈麯張%腹外疝%內鏡治療
간경화%식관위활정맥곡장%복외산%내경치료
Cirrhosis%Esophagogastric varices%Hernia%Endoscopic treatment
目的：汇总分析肝硬化合并食管胃底静脉曲张(Esophagogastric varices，EGV)和腹外疝的临床治疗情况，探讨内镜下治疗该类疾病的临床疗效和安全性。方法：以我院2008年3月至2013年4月间收治的17例肝硬化合并E V G和腹外疝的患者为研究对象，对其行内镜下治疗的临床疗效、安全性等进行汇总分析。结果：17例E G V患者中，行静脉套扎5例，静脉硬化治疗2例，静脉注射组织胶治疗4例，组织胶联合静脉套扎治疗6例。2周内17例患者中共计发生再出血事件2例，发生嵌顿疝3例次，经再次内镜下治疗和手法还纳处理后，静脉出血和嵌顿疝症状均消除。在并发症方面，以胸骨后疼痛、剑突下疼痛等为主要症状，可耐受，术后短期内即自行消除。1年随访结果显示，3例患者死亡，14例存活，死亡原因多由肝功能衰竭所致，未见其他后遗症。结论：内镜下治疗肝硬化患者食管胃底静脉曲张合并腹外疝，临床疗效明确、安全可靠，配合适当术中处理措施可降低嵌顿疝发生率。
目的：彙總分析肝硬化閤併食管胃底靜脈麯張(Esophagogastric varices，EGV)和腹外疝的臨床治療情況，探討內鏡下治療該類疾病的臨床療效和安全性。方法：以我院2008年3月至2013年4月間收治的17例肝硬化閤併E V G和腹外疝的患者為研究對象，對其行內鏡下治療的臨床療效、安全性等進行彙總分析。結果：17例E G V患者中，行靜脈套扎5例，靜脈硬化治療2例，靜脈註射組織膠治療4例，組織膠聯閤靜脈套扎治療6例。2週內17例患者中共計髮生再齣血事件2例，髮生嵌頓疝3例次，經再次內鏡下治療和手法還納處理後，靜脈齣血和嵌頓疝癥狀均消除。在併髮癥方麵，以胸骨後疼痛、劍突下疼痛等為主要癥狀，可耐受，術後短期內即自行消除。1年隨訪結果顯示，3例患者死亡，14例存活，死亡原因多由肝功能衰竭所緻，未見其他後遺癥。結論：內鏡下治療肝硬化患者食管胃底靜脈麯張閤併腹外疝，臨床療效明確、安全可靠，配閤適噹術中處理措施可降低嵌頓疝髮生率。
목적：회총분석간경화합병식관위저정맥곡장(Esophagogastric varices，EGV)화복외산적림상치료정황，탐토내경하치료해류질병적림상료효화안전성。방법：이아원2008년3월지2013년4월간수치적17례간경화합병E V G화복외산적환자위연구대상，대기행내경하치료적림상료효、안전성등진행회총분석。결과：17례E G V환자중，행정맥투찰5례，정맥경화치료2례，정맥주사조직효치료4례，조직효연합정맥투찰치료6례。2주내17례환자중공계발생재출혈사건2례，발생감돈산3례차，경재차내경하치료화수법환납처리후，정맥출혈화감돈산증상균소제。재병발증방면，이흉골후동통、검돌하동통등위주요증상，가내수，술후단기내즉자행소제。1년수방결과현시，3례환자사망，14례존활，사망원인다유간공능쇠갈소치，미견기타후유증。결론：내경하치료간경화환자식관위저정맥곡장합병복외산，림상료효명학、안전가고，배합괄당술중처리조시가강저감돈산발생솔。
Objective:To make a meta-analysis about the clinical treatment of the cirrhosis patients with esophagogastric varices and hernia, investigate the efifcacy and safety of endoscopic treatment. Methods:17 cases patients with cirrhosis patients with esophagogastric varices and hernia were the objects of this study, which had been treated in our hospital with endoscopy during 2008.03-2013.04, gather and compared the clinical effect and safety of endoscopic hemostasis.Results:Among 17 cases patients, 5cases received a treatment with vein ligation, 2 cases patients were treated by venous sclerosis, 4 cases treated by tissue glue injection, and 6 cases treated by vein ligation joint with tissue glue injection. Within postoperative 2 weeks, 2 cases occurred re-bleeding, 3 cases occurred incarcerated hernia, the symptoms were eliminate by again endoscopic therapy and techniques also satisfied. The results of complications showed, the chest pain, xiphoid pain, et al, were the main complications, could be tolerated and eliminate themselves after a short period. The results of1-year follow-up showed 3 cases death and 14 cases survived, the cause of death were liver failure, no other sequelae occurred.Conclusions:The hemostasis treatment under endoscopic has a clear clinical efifcacy and reliable safety, the incidence of incarcerated hernia could be reduced by add appropriate intraoperative management measures.
