粘合剂α-氰丙烯酸正辛酯治疗食管胃静脉曲张出血

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目的评价内镜下组织粘合剂α-氰丙烯酸正辛酯(D-TH液)治疗食管胃静脉曲张出血的临床疗效。方法将食管胃静脉曲张出血患者57例分成两组,A组的21例经内镜注射D-TH液,B组36例经内镜注射Histoacryl液,术后分别奥曲肽每天0.6mg静脉点滴2~3d。结果A组的急性出血者即时止血率为100%(10/10),B组为100%(17/17);两组的2周再出血率分别为5.0%(1/20)和2.8%(1/36)(P>0.05);3个月再出血率分别为5.0%(1/20)和8.6%(3/35)(P>0.05)。两组均未见明显并发症及副反应。粘合剂D-TH液原液注射法注射针堵塞发生率低于Histaocryl三明治注射法。结论粘合剂D-TH液原液注射法操作较简便,控制出血迅速有效,并发症发生率低,可在临床处理中应用。 Objective To evaluate the clinical efficacy of endoscopic tissue adhesive n-octyl α-cyanoacrylate (D-TH solution) in the treatment of gastroesophageal varices bleeding. Methods Fifty-seven patients with esophageal and gastric variceal bleeding were divided into two groups: 21 cases in group A received endoscopic D-TH injection, 36 cases in group B received endoscopic injection of Histoacryl liquid. After operation, octreotide 0.6 mg intravenously every day for 2 ~ 3d. Results The rate of immediate hemostasis was 100% (10/10) in group A and 100% (17/17) in group B. The rates of 2-week rebleeding were 5.0% (1/20) and 2.8% (1/36) (P> 0.05). The 3-month rates of rebleeding were 5.0% (1/20) and 8.6% (3/35) respectively (P> 0.05). No significant complications and side effects were observed in both groups. Adhesive D-TH solution injection liquid injection needle occlusion rate was lower than Histaocryl sandwich injection method. Conclusion The adhesive D-TH liquid injection method is simple and convenient, the control of bleeding quickly and effectively, the incidence of complications is low, and can be used in clinical treatment.
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