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目的 通过家犬门静脉高压致食道静脉曲张模型的建立 ,了解内镜结扎法 (EVL)对食道壁的病理变化 ,为临床治疗和预防门静脉高压症致食道静脉曲张破裂出血提供科学而可靠的实验依据。方法 先建立门静脉高压食道静脉曲张的家犬动物模型 ,然后应用EVL结扎曲张的食道静脉 ,分别于 30h、5d、1 5d、30d、56d处死动物 ,观察食道结扎部位的病理变化。结果 内镜结扎仅引起结扎局部粘膜和粘膜下层组织发生缺血 ,坏死和急性炎症反应。 4 - 5d坏死组织脱落后形成溃疡 ,2w后溃疡得以基本愈合 ,4w后创面完全愈合 ,表面完全上皮化 ,深层肌组织无任何损伤。结论EVL既可有效地根除曲张静脉达到止血和预防破裂出血的目的 ,又不影响食道壁肌层组织 ,可减少术后食道狭窄的发生率。但一次结扎可造成遗漏而需多次结扎 ,方可达满意疗效
Objective To establish a model of esophageal varices induced by portal hypertension in dogs to understand the pathological changes of esophageal wall by endoscopic ligation (EVL) and provide a scientific and reliable experimental basis for the clinical treatment and prevention of esophageal varices bleeding caused by portal hypertension . Methods Animal models of portal hypertension were established. Animals were sacrificed at 30h, 5d, 15d, 30d and 56d after EVL ligation of varicose veins. The pathological changes of esophagus ligation were observed. Results Endoscopic ligation only caused local, submucosal ligation of ischemia and necrosis, and acute inflammation. After 4-5 days, the necrotic tissue became ulcerated, and the ulcer was basically healed after 2 weeks. After 4 weeks, the wound healed completely, the surface completely epithelized, and the deep muscular tissue had no damage. Conclusion EVL can effectively eradicate varicose vein to prevent hemorrhage and stop the bleeding purposes, and does not affect the esophageal muscularis mucosa, can reduce the incidence of postoperative esophageal stenosis. But a ligation can result in missing and need to be ligation several times before reaching satisfactory results