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目的 :探讨食管静脉曲张多环套扎术的疗效及二种套扎器的结构和使用方法的差异。方法 :本组采用willsoncook ,6环、10环套扎器及Microrasive 5环、8环套扎器 ,对 47例食管静脉曲张患者进行了 5 8次内镜下多环套扎术 ,每例套扎 1～ 3次 ,平均 1.2次 ,每次套扎 4～ 11环 ,平均 5 .2环。结果 :食管静脉曲张基本消失12例 ,占 2 6 .8% ,曲张程度降低 1～ 2级 32例 ,占 6 9.5 6 % ,无改善 3例占 6 .5 2 % ,门脉高压性胃病加重 1例 ,术后 5～ 6d因再次出血死亡 3例 ,一年后再出血 2例 ,肝衰死亡 1例。结论 :多环套扎术对治疗食管曲张静脉是一种有效的治疗方法 ,但如何预防术中术后早期大出血尚需进一步探讨 ,目前使用的两种多环套扎器技术虽已成熟 ,但仍需加以改进和完善。
Objective: To investigate the curative effect of multi-ring ligation of esophageal varices and the difference of structure and using method of two ligation devices. Methods: In this study, 47 patients with esophageal varices were treated with willsoncook, 6-ring, 10-ring ligation and Microrasive 5-ring and 8-ring ligation. Bar 1 to 3 times, an average of 1.2 times, each ligation 4 ~ 11 rings, an average of 5.2 rings. Results: Esophageal varices basically disappeared in 12 cases, accounting for 26.8%. The degree of varicosity was reduced from 1 to 2 in 32 cases (6 9.56%). No improvement was found in 3 cases (6.52%), portal hypertensive gastropathy 1 patient died of rebleeding 5 days after operation, 3 patients died of rebleeding one year later 2 patients died of liver failure 1 patient. Conclusion: Polycyclic ligation is an effective treatment for esophageal varices. However, how to prevent intraoperative and early postoperative major hemorrhage remains to be further explored. Although the two multi-ligation techniques currently used are mature, Still need to be improved and perfected.