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目的探讨内镜下密集多点结扎术(DEVL)治疗食管静脉曲张出血的近远期疗效。方法对贲门口齿状线及以上5～6cm范围的曲张静脉密集多点结扎,每隔2～3周重复治疗,直至曲张静脉全部根治。术后3、6、12个月定期随访及胃镜复查,术后3个月结果作为近期疗效判断依据,6个月以后作为远期疗效判断依据。结果126例患者共完成403次、3641点结扎,平均每例结扎3.2次、28.9点。急诊止血率为100.0％;近期食管静脉曲张根治率为94.4％、总有效率为100.0％、复发出血率为3.9％;经过平均22.3个月随访,远期食管静脉曲张复发率为11.9％、复发出血率为3.2％、未见复发出血死亡。术后多数患者有一过性门静脉高压性胃病加重。结论DEVL治疗能有效急诊止血、根治食管静脉曲张和预防再出血,远期疗效较好。治疗不受肝功能状态的影响,并发症少。
Objective To explore the short-term and long-term efficacy of endoscopic intensive multi-point ligation (DEVL) in the treatment of esophageal variceal bleeding. Methods The cardia dentate line and the above 5 ~ 6cm varicose vein intensive multi-point ligation, repeated every 2 to 3 weeks until all varicose vein radical cure. Regular follow-up 3,6,12 months after surgery and endoscopy, 3 months after the results as the basis for the recent efficacy of judgments, 6 months later as the basis for long-term efficacy. Results 126 patients completed a total of 403 times, 3641 points ligation, the average of 3.2 cases per ligation, 28.9 points. The emergency cure rate was 100.0%. The recent cure rate of esophageal varices was 94.4%, the total effective rate was 100.0% and the recurrence rate was 3.9%. The recurrence rate of long-term esophageal varices was 11.9% after an average of 22.3 months follow-up Bleeding rate was 3.2%, no recurrence of bleeding deaths. Most postoperative patients with transient portal hypertensive gastropathy. Conclusion DEVL treatment can effectively treat emergency bleeding, cure esophageal varices and prevent rebleeding, and long-term curative effect is better. Treatment is not affected by the state of liver function, fewer complications.