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目的评价内镜食管静脉结扎法治疗食管静脉曲张出血远期疗效。方法采用内镜食管静脉结扎法治疗263例食管静脉曲张出血病人,每隔2周重复结扎治疗,直至曲张静脉完全闭塞。结果 238例生存期超过3个月的病人中有216例(91%)曲张静脉被根治,曲张静脉的根治需平均结扎治疗4次。全组1、3、5年累积生存率分别是76%、62%、57%。生存率主要取决于肝功能状况。死亡56例(21%),主要死因是肝功能衰竭。再出血主要发生在治疗早期,曲张静脉根治后再出血明显减少。再出血率为155(39/263)。结论内镜食管静脉结扎法是治疗食管静脉曲张出血安全有效的方法;重复该法治疗多数情况下可根治曲张静脉,降低再出血率;坚持内镜食管静脉结扎法治疗可减少再出血导致的死亡,延长曲张静脉出血病人的生存期。
Objective To evaluate the long-term efficacy of endoscopic esophageal vein ligation in the treatment of esophageal variceal bleeding. Methods Endoscopic esophageal vein ligation was used to treat 263 patients with esophageal varices bleeding. The treatment was repeated every 2 weeks until the varicose veins were completely occluded. Results Of the 238 patients with survival of more than 3 months, 216 (91%) were cured with varicose veins and the varicose veins were treated with an average of 4 ligations. The 1, 3, 5 year cumulative survival rates were 76%, 62% and 57% respectively. Survival rate depends mainly on liver function status. 56 cases died (21%), the main cause of death is liver failure. Rebleeding occurs mainly in the early treatment, variceal bleeding after radical reduction was significantly reduced. The rate of rebleeding was 155 (39/263). Conclusion Endoscopic esophageal vein ligation is a safe and effective method for the treatment of esophageal variceal bleeding. Repeated this treatment can cure variceal vein in most cases and reduce the rate of rebleeding. Insufficient endoscopic esophageal vein ligation can reduce the death caused by rebleeding , To extend the survival of patients with variceal bleeding.