食道静脉套扎术后的并发症护理(1)
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【摘要】目的 探索胃镜套扎止血医治肝硬化食管静脉曲张破裂出血患者之疗效以及护理的注意事项。方法 对42例肝硬化患者施行胃镜检查，确诊食管静脉曲张，对曲张静脉施行急诊、择期单次或者几次套扎，此中20例食管静脉曲张破裂出血患者施行急诊胃镜检查并行胃镜下套扎术，22例施行择期胃镜下套扎术，术后进行细致护理。结果 42例肝硬化食管静脉曲张套扎术患者中38例在术后2～3周复查胃镜，静脉曲张地步均匀显著减低，部分患者静脉曲张彻底消减，急诊和择期胃镜下套扎术止血安全率均匀在90%以上。结论 可以认为胃镜下食管静脉曲张套扎术是治疗食管静脉曲张破裂出血和预防出血的有用措施，术后要根据患者的具体病情给予护理。
【关键词】食管静脉曲张破裂出血 并发症 护理
中图分类号：R473.5文献标识码：A文章编号：1005-0515(2011)10-007-02
Complications of esophageal ligation postoperative care
FAN Pingzhi
(First People's Hospital of Sichuan Guangyuan Guangyuan, Sichuan 628017)
【Abstract】Objective To explore the endoscopic ligation treatment of bleeding esophageal varices in patients with cirrhosis of the efficacy and care considerations. Methods 42 patients with cirrhosis underwent endoscopy, diagnosis of esophageal varices, varicose veins on the implementation of the emergency, elective single or several ligation, herein 20 cases of esophageal variceal bleeding underwent emergency gastroscopy parallel stomach endoscopic ligation, 22 patients underwent elective endoscopic ligation, and meticulous postoperative care. Results 42 cases of liver cirrhosis patients with esophageal variceal ligation in 38 cases in the 2 to 3 weeks after the endoscopy, the point of even significantly reduce varicose veins, varicose veins in some patients completely cut, emergency and elective endoscopic ligation security uniform rate of bleeding in 90%. Conclusion that endoscopic variceal ligation is the treatment of esophageal variceal bleeding and prevention of bleeding of useful measures, patients should be given under the care of patients with specific conditions.
【Keywords】Esophageal variceal bleeding complications of care
肝硬化食管静脉曲张破裂出血就是肝硬化门静脉高压症患者之致命性并发症，其亡命率高达百份之五十左右。我院运用胃镜下食管静脉曲张套扎术(EVL) 医治食管静脉曲张，收到了优良之医治成效，现报道如下：
1 临床材料
1.1 一般材料
本组42例肝硬化门静脉高压症食管静脉曲张患者，男性30例，女性12 例，年纪28～70岁，平均(50.03±3.52)岁。肝炎后肝硬化34例(80.95%)，酒精性肝硬化5例(11.90%)，病因不明3例(7.25%);有出血史26例(61.90%)，无出血史16例(38.10%);急性破裂出血20例，出血时候间3 h～3 d,大出血18例，4例出现低血容量性休克，经扩容等医治后休克基础更正。肝功能遵循Child分级，A级12例，B级21例，C级9例。内镜诊断：20例急性破裂出血患者胃镜下见食管和胃腔鲜血染，可见3～5条纵行呈灰蓝色串珠状或者结节状之Ⅲ°以上曲张静脉(soehendra食管、胃底曲张静脉分度法)，局部管腔狭隘，从距门齿26 cm伸展至贲门，曲张静脉表面黏膜有差别地步陈旧迂腐、出血。在实验中有22例，没出血者的食管静脉曲张在Ⅱ°以上，经过统计数量达到3条。在患者经胃镜检查中，确立诊断中之后重度食管静脉曲张。例子应证：无胃镜检查禁忌；非急性出血外形或者曾基础更正；药物和三腔二囊管压抑止血无效者 ......
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