凝血酶——治疗胃静脉曲张出血的有效方法。
Thrombin--an effective treatment for gastric variceal haemorrhage.
作者信息
Williams S G, Peters R A, Westaby D
机构信息
Department of Gastroenterology, Charing Cross Hospital, London.
出版信息
Gut. 1994 Sep;35(9):1287-9. doi: 10.1136/gut.35.9.1287.
The optimum treatment of gastric varices has still to be defined. Lesser curve gastric varices may be treated by injection sclerotherapy, but this has a limited role in the treatment of fundal gastric varices. Surgical intervention is commonly needed but carries a high mortality in patients with advanced liver disease. This study evaluated the use of thrombin for the treatment of gastric varices in 11 consecutive patients (nine with fundal, two with high lesser curve varices), identified as having bled from this site. Bovine thrombin (1000 U/ml) was injected intravariceally (mean volume 5.5 ml, range 2-10 ml) producing initial haemostasis in all 11 cases. Varices were considered thrombosed or obliterated in all patients after a median of two injection episodes (range 1-3). After a median follow up of nine months only one patient had rebled from a gastric varix. Thrombin may represent a valuable alternative injectate for the treatment of gastric varices.
胃静脉曲张的最佳治疗方法仍有待确定。胃小弯侧静脉曲张可通过注射硬化疗法进行治疗，但该方法在治疗胃底静脉曲张方面作用有限。通常需要进行手术干预，但晚期肝病患者手术死亡率较高。本研究评估了凝血酶用于治疗11例连续患者胃静脉曲张的效果（9例胃底静脉曲张，2例胃小弯高位静脉曲张），这些患者均被确定为该部位出血。将牛凝血酶（1000 U/ml）经静脉内注射（平均剂量5.5 ml，范围2 - 10 ml），11例患者均实现了初步止血。在平均两次注射（范围1 - 3次）后，所有患者的静脉曲张均被认为已形成血栓或闭塞。在平均随访9个月后，仅有1例患者胃静脉曲张再次出血。凝血酶可能是治疗胃静脉曲张的一种有价值的替代注射剂。
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