Saeed Z A, Michaletz P A, Winchester C B, Woods K L, Dixon W B, Hieser M C, Gentry K R, Ramirez F C
Department of Medicine, Baylor College of Medicine, Houston, Texas.
Gastrointest Endosc. 1990 Nov-Dec;36(6):572-4. doi: 10.1016/s0016-5107(90)71166-2.
Endoscopic variceal ligation has been developed as an alternative to endoscopic sclerotherapy. We report a series of 12 men with a history of bleeding esophageal varices who were treated with endoscopic variceal ligation after they had failed sclerotherapy. Hemostasis was achieved in all 10 patients who were bleeding at the time of initial endoscopy and again in those who subsequently re-bled. Over a follow-up period of up to 22 months, varices have been and remain eradicated in five patients; in four others, a reduction in grade was noted before death (two patients), liver transplant, or loss to follow-up (one patient each); two patients died before they could be re-evaluated, while in the remaining patient, no reduction in variceal grade was noted before loss to follow-up. No complication was recorded after 35 endoscopic treatment sessions involving a total of 245 rubber band ligations. Our results indicate that endoscopic variceal ligation may be used with success in patients who fail sclerotherapy.
内镜下静脉曲张套扎术已发展成为内镜下硬化治疗的替代方法。我们报告了一组12例有食管静脉曲张出血史的男性患者，他们在硬化治疗失败后接受了内镜下静脉曲张套扎术。在初次内镜检查时出血的所有10例患者以及随后再次出血的患者中均实现了止血。在长达22个月的随访期内，5例患者的静脉曲张已被根除且仍保持根除状态；另外4例患者，在死亡（2例患者）、肝移植或失访（各1例患者）前静脉曲张分级有所降低；2例患者在能够重新评估之前死亡，而在其余患者中，在失访前未观察到静脉曲张分级降低。在总共245次橡皮圈套扎的35次内镜治疗后未记录到并发症。我们的结果表明，内镜下静脉曲张套扎术可成功用于硬化治疗失败的患者。
