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目的:为评估凝血酶在肝性上消化道出血的的疗效,我们对187例各型肝病合并上消化道出血患者使用凝血酶止血治疗。其中急肝6例,亚急重肝5例,慢活肝31例,肝炎后肝硬化145例。方法:①食管静脉栓塞硬化治疗;②镜下出血部位喷洒;③口服或经胃管注入。结果:22例用凝血酶栓塞者,72h内出血完全控制,7d和6周后曲张静脉消失率分别为56.1％(50/89)和82.0％(73/89)。96例镜下直接喷洒者77例显效。23例经胃管注入者17例出血停止。46例口服流血酶者44例3d内便潜血转阴。结论:凝血酶在控制肝性上消化道出血方面安全有效。可做为食管静脉栓塞剂使用。
OBJECTIVE: To assess the efficacy of thrombin in hepatic upper gastrointestinal hemorrhage, we used thrombin hemostasis in 187 patients with various types of liver disease complicated with upper gastrointestinal bleeding. Including acute liver in 6 cases, subacute severe hepatitis in 5 cases, slow-living liver in 31 cases, 145 cases of post-hepatitis cirrhosis. Methods: ① esophageal and vein embolization sclerotherapy; ② bleeding under the microscope spraying; ③ oral or gastric tube injection. Results: Twenty-two patients with thrombin embolization were completely controlled within 72 hours. The disappearance rates of varicose vein were 56.1% (50/89) and 82.0% (73/89) after 7 and 6 weeks respectively. Ninety-seven patients undergoing direct microscopy under microscope were found to be effective. Twenty-three of 23 patients who had been injected with gastric tube stopped bleeding. Forty-four cases of oral gastrectomy in 46 cases occured occult blood and turned negative. Conclusion: Thrombin is safe and effective in controlling hepatic upper gastrointestinal bleeding. Can be used as esophageal vein embolization agent.