Shrestha B, Kc S, Chaudhary S, Basnet B K, Mandal A K, Poudyal N S
Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
Hepatology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2017 Apr-Jun;56(206):198-202.
Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices.
This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017. Consecutive cases who presented in emergency room with acute variceal bleeding due to liver cirrhosis and cases of liver cirrhosis with large varices and red color signs on endoscopic examination were enrolled. They underwent EVL and subsequent re-endoscope at one month interval till the eradication of varices was achieved.
Among 83 patients, 15 (18.1%) were of Child Pugh class A, 29 (34.9%) B and 39 (47%) were of C. In 20 (24.1%) cases varices could be eradicated in one session of EVL while 57 (68.7%) required two sessions and in 6 (7.2%) cases it took three sessions. Total average EVL session required for obliteration of esophageal varices was 1.84±0.53. There was only one (1.2%) of early re-bleeding post EVL.
EVL is an effective modality of treatment in controlling acute esophageal variceal bleeding, in preventing future variceal bleeding as well as in eradicating esophageal varices with very few complications.
肝硬化患者食管静脉曲张出血是一种死亡率很高的急症。治疗食管静脉曲张的首选方法之一是内镜下套扎术(EVL)。我们旨在了解内镜下套扎术在控制急性食管静脉曲张出血、预防性套扎以预防未来出血以及完全消除静脉曲张所需的套扎次数方面的效果。
这项描述性观察性研究于2016年6月至2017年5月在尼泊尔医学科学院比尔医院的胃肠病学和肝病科进行。纳入因肝硬化出现急性静脉曲张出血而在急诊室就诊的连续病例,以及内镜检查发现有大静脉曲张和红色征的肝硬化病例。他们接受了内镜下套扎术,并在一个月的间隔后进行再次内镜检查,直到静脉曲张消除。
83例患者中,15例(18.1%)为Child Pugh A级,29例(34.9%)为B级,39例(47%)为C级。20例(24.1%)患者在一次内镜下套扎术中静脉曲张得以消除,57例(68.7%)需要两次套扎,6例(7.2%)需要三次套扎。消除食管静脉曲张所需的内镜下套扎术总平均次数为1.84±0.53。内镜下套扎术后仅1例(1.2%)发生早期再出血。
内镜下套扎术是控制急性食管静脉曲张出血、预防未来静脉曲张出血以及消除食管静脉曲张的一种有效治疗方法,并发症极少。