Svoboda P, Ochmann J, Kantorová I, Sefr R
Výzkumný ústav traumatologie a speciální chirurgie, Brno.
Vnitr Lek. 1993 Apr;39(4):359-63.
The authors treated during the past three years 312 patients with oesophageal varices after the first haemorrhage. All patients were treated by endoscopic sclerotization of oesophageal varices and drugs which reduce the excessive portal pressure. After a minimum of two sclerotherapeutic sessions, following control of acute haemorrhage, the authors observed a relapse of haemorrhage from the upper gastrointestinal tract in 38 patients. In 20 of them the relapse of haemorrhage was again from oesophageal varices, but in 18 patients it was of different origin and would not be affected by classical treatment with a Sengstaken tube. The authors draw attention to the necessity of emergency endoscopy in these patients and to the fact that possible postponement of rational treatment, e.g. in duodenal ulcers insertion of a tube, may threaten the patient's life.
在过去三年中,作者对312例首次出血后发生食管静脉曲张的患者进行了治疗。所有患者均接受了食管静脉曲张内镜硬化治疗以及降低门静脉压力过高的药物治疗。在急性出血得到控制后,至少进行两次硬化治疗后,作者观察到38例患者上消化道出血复发。其中20例出血复发仍源于食管静脉曲张,但18例患者出血来源不同,使用三腔二囊管进行的传统治疗对此无效。作者提请注意这些患者进行急诊内镜检查的必要性,以及合理治疗可能被推迟(例如十二指肠溃疡患者插管延迟)可能危及患者生命这一事实。