无碘油稀释氰基丙烯酸酯在预防性治疗胃静脉曲张中的应用

发布时间：2018-06-24 16:22

本文选题：氰基丙烯酸酯 + 胃静脉曲张　；参考：《中国内镜杂志》2015年05期

【摘要】：目的评价无碘油稀释氰基丙烯酸酯(NBCM)在内镜预防治疗胃静脉曲张的有效性与安全性。方法收集2012年1月-2012年10月该院20例门静脉高压症胃静脉曲张(GV)患者伴或不伴食管静脉曲张(EV),懫用无碘油组织粘合剂NBCM治疗处理。采用生理盐水、α-氰基丙烯酸酯和生理盐水夹心法治疗。内镜证实出血停止,治疗0.5 d后患者无呕血及便血等现象,生命体征平稳。记录患者术中、术后并发症。所有患者术后接受随访,记录出血复发及其他不良事件。结果 20例门静脉高压伴胃底静脉曲张患者接受NBCM内镜预防性治疗。18例(90%)患者曾采用内镜套扎(EBL)术治疗EV,其余患者无EV。13例(65%)患者在第1疗程(1期)治疗中GV闭塞,7例(35%)患者在第2疗程(2期)治疗中GV闭塞,平均NBVM用量为(1.37±0.48)ml。6个月随访中,仅1例(5%)患者GV复发,1例患者在第35个月随访中经内镜超声确认GV复发。总体而言,在6~40个月,中数31个月的随访中,GV复发率为10%,出血率为5%。该组病例未发现死亡案例,3例患者(15%)报告存在轻度胃痛,其与患者未发现严重不良事件(全身性栓塞、败血症或胃肠道出血)。结论无碘油NBCM内镜注射是胃静脉曲张性出血的一种安全有效的初始预防性治疗方式。
[Abstract]:Objective to evaluate the efficacy and safety of iodized oil diluted cyanoacrylate (NBCM) in endoscopic prophylaxis of gastric varices. Methods from January 2012 to October 2012, 20 patients with or without esophageal varices (EV) with portal hypertension were treated with NBCM. Normal saline, 伪-cyanoacrylate and normal saline sandwich method were used. The bleeding was stopped by endoscopy, and no hematemesis and hematochezia were found after 0.5 d treatment. The vital signs were stable. Postoperative complications were recorded. All patients were followed up to record recurrent bleeding and other adverse events. Results Twenty patients with portal hypertension and varicose gastric fundus were treated with NBCM endoscopic prophylaxis. 18 patients (90%) had been treated with endoscopic ligation (EBL). The rest had no EV.13 patients (65%) with GV occlusion during the first course of treatment (stage 1). GV occlusion was found in 7 patients (35%) during the second course of treatment (stage 2). The average dosage of ml.6 was (1. 37 卤0. 48) months follow-up, only 1 patient (5%) had GV recurrence and 1 patient had confirmed GV recurrence by endoscopic ultrasound during the 35 months follow-up. In general, the recurrence rate of GV was 10 and the bleeding rate was 50.In the follow-up of 6-40 months and 31 months, the recurrence rate of GV was 10 and the bleeding rate was 5. Three patients (15%) reported mild stomach pain, and no severe adverse events (systemic embolism, septicemia or gastrointestinal bleeding) were found in this group. Conclusion Endoscopic injection of non-lipiodol NBCM is a safe and effective initial prophylactic treatment for gastric variceal hemorrhage.
【作者单位】：杭州市余杭区第五人民医院消化内科消化内镜中心;浙江省医学院附属第二医院消化内科;
【分类号】：R575.2

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