Kim D O, Ul'ianov D N, Vasnev O S
Eksp Klin Gastroenterol. 2012(6):58-61.
The problem of prevention of variceal bleeding (VB) of esophagus and stomach in patients with portal hypertension has not lost its relevance due to the high mortality rates (reaching 50% at relapse), as a result of the objective difficulties of implementation of efficient primary hemostasis and subsequent control of recurrent bleeding and adequate correction of coagulopathy, and decompensated liver function. Endoscopic ligation of esophageal VB latex rings or plastic endo loop continues to be the standard prevention of bleeding of portal genesis (Baveno IV, V). However, according to several authors, endoscopic ligation by latex rings should not be used in the propagation of VB on the stomach (as well as the presence of VB isolated stomach) because of the danger of destruction latex by gastric juice. At the same time, the latex ligation is much easier technically, faster, and therefore, it is easier tolerated, and most importantly, do not poses a threat to the strain varices difficult to stop the bleeding which in some cases observed at tightening of the plastic endoloop. In this study proved the possibility to reach the comparative safety and efficacy of gastric banding Varices with latex rings.
由于高效的原发性止血、后续复发性出血的控制以及凝血功能障碍和失代偿肝功能的充分纠正存在客观困难,导致门静脉高压患者食管和胃静脉曲张出血(VB)的预防问题仍然具有相关性,其复发时的高死亡率(可达50%)即是证明。食管VB乳胶环或塑料内镜圈套器的内镜结扎仍然是门静脉源性出血(巴韦诺IV、V)的标准预防方法。然而,根据一些作者的观点,由于胃液破坏乳胶的风险,乳胶环内镜结扎不适用于胃静脉曲张的扩展(以及孤立性胃静脉曲张的存在)。同时,乳胶结扎在技术上要容易得多、速度更快,因此更容易耐受,最重要的是,不会对难以止血的曲张静脉造成威胁,而在收紧塑料内镜圈套器时,在某些情况下会观察到这种情况。本研究证明了使用乳胶环进行胃静脉曲张结扎达到相对安全性和有效性的可能性。