Gómez Senent Silvia, Martín Arranz María Dolores, Froilán Torres Consuelo, Manceñido Marcos Noemí, Martín Chavarri Sonia, Carrión Alonso Gemma, Suárez de Parga José, Segura Cabral José María
Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, Spain.
Gastroenterol Hepatol. 2006 Jun-Jul;29(6):323-6. doi: 10.1157/13089712.
The aim of the present study was to determine the usefulness of elastic band ligation in the prevention of hemorrhage recurrence due to esophageal-gastric varices. Sixty-five patients who survived an episode of variceal hemorrhage were included in the study. Twenty-nine patients (45%) were Child-Pugh class A, 25 (38%) were class B, and 11 (17%) were class C. The cause of cirrhosis was hepatitis C virus and alcohol in 45% and 31% of the patients, respectively. The first ligation session was performed between the third and fifth day after the hemorrhagic episode and subsequent sessions were carried out at intervals of 3-4 weeks. The ligation sessions were performed with antibiotic prophylaxis. A mean of 2.7 bands were placed per session (range 1-5), and the mean number of sessions required per patient to achieve variceal eradication was 2.5 (range 1-6). The rate of bleeding recurrence was 24.6% (16 episodes). In conclusion, endoscopic elastic band ligation is a useful technique for the eradication of esophageal varices and for the prevention of bleeding recurrence.
本研究的目的是确定弹性橡皮圈套扎术在预防食管胃静脉曲张出血复发方面的有效性。65例静脉曲张出血发作后存活的患者纳入本研究。29例（45%）患者为Child-Pugh A级，25例（38%）为B级，11例（17%）为C级。分别有45%和31%的患者肝硬化病因是丙型肝炎病毒和酒精。首次套扎在出血发作后的第3至5天进行，随后的套扎每隔3至4周进行一次。套扎操作时使用抗生素预防感染。每次套扎平均放置2.7个橡皮圈（范围1至5个），每位患者实现静脉曲张根除所需的平均套扎次数为2.5次（范围1至6次）。出血复发率为24.6%（16次发作）。总之，内镜下弹性橡皮圈套扎术是根除食管静脉曲张和预防出血复发的有效技术。
