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目的:观察经鼻内镜检查引导下通过改良三腔二囊管加沙氏导丝引导支撑,结合内镜下硬化剂治疗肝硬化食管静脉曲张破裂出血的疗效。方法:14例肝硬化食道静脉曲张破裂出血患者经过经鼻内镜检查后通过改良的三腔二囊管加沙氏导丝支撑下,结合内镜下硬化剂治疗食管静脉曲张破裂出血,观察止血效果以及并发症。结果:14例患者均1次止血成功,1例患者治疗后8 h再次出血,行急诊TIPSS手术治疗。主要反应为胸骨后疼痛,持续时间为2~7 d,对症处理后消失,3、6个月后再次复查食道胃底曲张静脉明显改善,3例10 d左右行内镜下再次硬化治疗(因第1次硬化剂量少或治疗不完全)。结论:经鼻内镜检查行改良三腔二囊管加沙氏导丝引导支撑下,结合内镜下硬化剂治疗肝硬化食管静脉曲张破裂出血是一种有效的治疗方法。
OBJECTIVE: To observe the curative effect of nasal endoscopy under the guidance of improved triple-lumen BJS and guide wire scaffolds combined with endoscopic sclerotherapy in the treatment of esophageal variceal hemorrhage with cirrhosis. METHODS: Fourteen patients with cirrhosis esophageal variceal bleeding under endoscopic sinus surgery were treated with modified triple-lumen biceps jesus wire, combined with endoscopic sclerotherapy to treat esophageal variceal hemorrhage, and the hemostatic effect was observed And complications. Results: All the 14 patients were successful in stopping the bleeding once, and one patient bleed again 8 h after the operation. The patients underwent emergency TIPSS operation. The main reaction was post-sternal pain lasting 2-7 days and disappeared after symptomatic treatment. The gastroesophageal varices were significantly re-examined after 3 and 6 months, and 3 cases underwent endoscopic re-sclerosis The first sclerosis dose or treatment is incomplete). CONCLUSIONS: Endoscopic nasal endoscopy is an effective treatment for patients with esophageal variceal bleeding due to cirrhosis of the liver under the guidance of a modified triple-lumen capillaries guidewire.