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食管静脉曲张经内窥镜注射硬化剂(EIS)后常发生浅表性溃疡,且可能因此造成出血而推迟以后的硬化术。本文介绍治疗硬化术后食管溃疡出血的一项新方法。作者对34例主要是慢性酒精性肝病的男性病人做了74次EIS。根据每个病人的情况,经内窥镜注射器将1～3ml5%的鱼肝油酸钠注入食管下端的曲张静脉内。术后6例(占病人的17.6%,硬化术次数的8.1%)在2周内发生溃疡,其中5例因溃疡而推迟了以后的硬化术,4例(11.7%)有持续数天的渗血,需输血平均2.4个单位。制酸剂、甲氰咪呱或血管加压素对渗血均无效。作者将硫糖铝1.0 g研末加入5ml甘油中制成悬液,每6小时口服一次。给药2天后,内窥镜见硫糖铝已很好地粘附到溃疡
Superficial ulcers often develop following endoscopic injection of sclerosing agent (EIS) in esophageal varices and may result in bleeding that delays later sclerosis. This article describes a new method of treating esophageal ulcer bleeding after sclerosis. The authors performed 74 EISs on 34 male patients with predominantly chronic alcoholic liver disease. Depending on the patient’s condition, 1 to 3 ml of 5% sodium morrhuate is infused into the varicose vein at the lower end of the esophagus via an endoscopic syringe. Six patients (17.6% of patients and 8.1% of sclerosis) developed ulceration within 2 weeks postoperatively, 5 of whom postponed subsequent sclerosis due to ulceration, and 4 (11.7%) had perspiration for several days Blood, blood transfusion required an average of 2.4 units. Antacids, cimetidine or vasopressin are ineffective on bleeding. The author sucralfate 1.0 g into the end of 5ml glycerol suspension was made, once every 6 hours orally. Two days after dosing, sucralfate was found to adhere well to the ulcer endoscopically