论文部分内容阅读
本文介绍一例经内窥镜反复注射硬化剂治疗食管静脉曲张出血成功,但后有直肠曲张静脉大出血。病人女性,74岁,出现直肠大量出血,血色鲜红。4年半前曾诊断患有原发性胆汁性肝硬变。3年后出现食管静脉曲张出血,在随访的8个月中,需经内窥镜注射硬化剂治疗,应用5%油酸氨乙醇,注射9次,共75 ml。食管静脉曲张出血完全停止。体检发现病人呈贫血和黄疸。腹部检查发现肝脾肿大和腹水。直肠有活跃的鲜红色出血,乙状结肠镜检见直肠内充满大量鲜血块。血色素6.2 g/dl,血清胆红素103μmol/L,血小板计数226×10(?)/L。凝血机制检查正常。上消化道的内窥镜检未发现食管出血。
This article describes a case of repeated endoscopic injection of sclerotherapy for esophageal variceal bleeding success, but after a large variceal bleeding. Female patient, 74 years old, a large number of rectal bleeding, scarlet red. 4 years and a half ago had a diagnosis of primary biliary cirrhosis. Esophageal variceal bleeding occurred 3 years later. During the follow-up period of 8 months, an endoscopic injection of sclerotherapy was required. A total of 75 ml of 5% oleic acid ammonia-ethanol was injected 9 times. Esophageal varices completely stopped bleeding. Physical examination revealed anemia and jaundice. Abdominal examination found hepatosplenomegaly and ascites. Rectum bright red bleeding, sigmoidoscopy see the rectum filled with a large number of blood clots. Hemoglobin 6.2 g / dl, serum bilirubin 103 mol / L, platelet count 226 × 10 (?) / L. Coagulation mechanism check normal. Upper gastrointestinal endoscopy showed no esophageal bleeding.