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内镜下应用组织胶和套扎术治疗儿童食管胃静脉曲张出血16例临床观察
Clinical effect of endoscopic application of tissue adhesive and ligation in treatment of esophagogastric variceal bleeding in children: An analysis of 16 cases
文章发布日期:2018年08月06日  来源:  作者:彭益秋,王拥军  点击次数:374次  下载次数:54次

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【摘要】:目的评估内镜下应用组织胶和套扎术治疗儿童食管胃静脉曲张出血的临床疗效。方法分析首都医科大学附属北京友谊医院2010年5月-2017年5月因食管胃静脉曲张出血接受内镜下治疗的16例患儿的临床资料。分析患儿术前情况及生理指标,术后的止血率、再出血率、并发症与进一步治疗情况。结果16例患儿平均(8.50±4.97)岁,5例表现为单纯食管静脉曲张,其中中度(GⅡ型)1例,重度(GⅢ型)4例,11例表现为食管静脉曲张合并胃静脉曲张,其中GOV1型6例(合并GⅠ型1例,GⅡ型3例,GⅢ型2例),GOV2型5例(合并GⅡ型2例,GⅢ型3例)。16例患儿食管静脉曲张共50条,平均每例4(1~5)条,共行套扎70处,平均每例5(0~8)处。9例行组织胶注射,共注射15点,使用组织胶20 ml,平均每例应用2.22 ml,平均每处注射1.33 ml。内镜治疗后即刻止血率为100%,3个月内再出血率为6.25%(1/16),3个月以上的随访过程中,再出血率为12.5%(2/16)。随访时间3个月~7年,随访期间4例行肝移植手术,1例因出血再次行内镜治疗,全部患儿均未见明显并发症。结论内镜下应用组织胶和套扎术治疗儿童食管胃静脉曲张出血止血明确,并发症少,为患者的远期治疗提供了宝贵时间。
【Abstract】:ObjectiveTo investigate the clinical effect of endoscopic application of tissue adhesive and ligation in the treatment of esophagogastric variceal bleeding in children. MethodsA retrospective analysis was performed for the clinical data of 16 children who underwent endoscopic treatment due to esophagogastric variceal bleeding from May 2010 to May 2017. Preoperative conditions and physiological indices and postoperative hemostasis rate, rebleeding rate, complications, and further treatment. ResultsThe mean age of these children was 8.50±4.97 years. Of all children, 5 had esophageal varices alone, among whom 1 had moderate (GII) type and 4 had severe (GIII) type, and 11 had esophageal varices complicated by gastric varices, among whom 6 had GOV1 type (1 complicated by GI type, 3 complicated by GII type, and 2 complicated by GIII type) and 5 had GOV2 type (2 complicated by GII type and 3 complicated by GIII type). There were a total of 50 varicose veins in these 16 children, with a mean number of 4 veins (range 1-5) in each child, and ligation was performed for 70 sites in total, with a mean number of 5 sites (range 0-8) in each child. Tissue adhesive injection was performed for 9 children at a total of 15 sites, and 20 ml of tissue adhesive was used in total, with 2.22 ml for each child and 1.33 ml for each site. The hemostasis rate immediately after endoscopic therapy was 100%, and the rebleeding rate was 6.25% (1/16) within 3 months and 12.5% (2/16) after 3 months. The follow-up time ranged from 3 months to 7 years, and during follow-up, 4 children underwent liver transplantation and 1 underwent endoscopic treatment again due to bleeding. No obvious complications were observed. ConclusionIn the treatment of esophagogastric variceal bleeding in children, endoscopic application of tissue adhesive and ligation has a marked hemostatic effect and few complications and provides valuable time for long-term treatment.
【关键字】:食管和胃静脉曲张; 胃镜检查; 治疗学; 儿童
【Key words】:esophageal and gastric varices; gastroscopy; therapeutics; child
【引证本文】:PENG YQ, WANG YJ. Clinical effect of endoscopic application of tissue adhesive and ligation in treatment of esophagogastric variceal bleeding in children: An analysis of 16 cases[J]. J Clin Hepatol, 2018, 34(9): 1921-1924. (in Chinese)
彭益秋, 王拥军. 内镜下应用组织胶和套扎术治疗儿童食管胃静脉曲张出血16例临床观察[J]. 临床肝胆病杂志, 2018, 34(9): 1921-1924.

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