食管静脉曲张出血的长期随访
Bleeding oesophageal varices with long term follow up.
作者信息
Spence R A, Johnston G W, Odling-Smee G W, Rodgers H W
出版信息
Arch Dis Child. 1984 Apr;59(4):336-40. doi: 10.1136/adc.59.4.336.
Complete long term follow up was obtained in 27 children who had bled from oesophageal varices. Most presented with haematemesis or melaena at an average age of 5.2 years in the portal vein thrombosis group (20 children) and 9.5 years in the intrahepatic group (7 children). All had splenomegaly. Only 6 of 20 children with portal vein thrombosis had a possible precipitating factor. A total of 182 admissions for bleeding are reported, in 68 of which injection sclerotherapy was used to control bleeding. Control rate with injection sclerotherapy was 97%. Shunts performed below age 10 years were associated with a high thrombosis rate. A conservative approach to bleeding varices in children is recommended with transfusion, pitressin, and injection sclerotherapy. Oesophageal transection may have a role in the emergency management of the few children in whom bleeding is not controlled by injection sclerotherapy.
对27例曾因食管静脉曲张出血的儿童进行了完整的长期随访。大多数患儿出现呕血或黑便，门静脉血栓形成组（20例患儿）的平均年龄为5.2岁，肝内组（7例患儿）为9.5岁。所有患儿均有脾肿大。20例门静脉血栓形成患儿中只有6例有可能的诱发因素。共报告了182次出血入院情况，其中68次采用注射硬化疗法控制出血。注射硬化疗法的控制率为97%。10岁以下进行分流术的血栓形成率较高。建议对儿童静脉曲张出血采取保守治疗方法，包括输血、使用垂体后叶素和注射硬化疗法。对于少数注射硬化疗法无法控制出血的儿童，食管横断术可能在急诊处理中发挥作用。
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