中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (21): 3961-3964.doi: 10.3969/j.issn.1673-8225.2011.21.038

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

套扎环、组织胶及硬化剂治疗食管胃底静脉曲张的方案选择及其效果

赵冬梅，安红军，贾珊珊   

  1. 齐齐哈尔市第一医院消化内科，黑龙江省齐齐哈尔市      161005
  • 收稿日期:2010-11-25 修回日期:2011-03-08 出版日期:2011-05-21 发布日期:2011-05-21
  • 作者简介:赵冬梅，女，1970年生，黑龙江省齐齐哈尔市人，汉族，1993年哈尔滨医科大学毕业，副主任医师，主要从事消化内科临床及消化内镜治疗方面的研究。 zhaodongmei169@163.com

Ligation ring, tissue adhesive and sclerotherapy for esophageal varices

Zhao Dong-mei, An Hong-jun, Jia Shan-shan   

  1. Department of Digestion, First Hospital of Qiqihar, Qiqihar  161005, Heilongjiang Province, China
  • Received:2010-11-25 Revised:2011-03-08 Online:2011-05-21 Published:2011-05-21
  • About author:Zhao Dong-mei, Associate chief physician, Department of Digestion, First Hospital of Qiqihar, Qiqihar 161005, Heilongjiang Province, China zhaodongmei169@163.com

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753

被引次数

59

摘要：

背景：目前经内镜硬化剂、经内镜套扎、组织胶栓塞治疗食管胃底静脉曲张的疗效已经获得公认，但各种方法的疗效存在差异。
目的：通过阐述套扎环、组织胶、硬化剂的材料学特征及其生物相容性，探讨食管胃底静脉曲张内镜下套扎、硬化及组织胶栓塞的治疗效果。
方法：采用电子检索的方式，在中国期刊全文数据库(CNKI：1989/2009)及Medline数据库(1989/2009)中检索有关套扎环、组织胶、硬化剂生物相容性及其治疗食管胃底静脉曲张的文献，以“食管胃底静脉曲张，套扎环，硬化剂，组织胶，治疗”及“cerebrovascular disease，stent，therapy”为检索词。排除重复研究、动物试验类基础研究或Meta分析类文章，筛选纳入17篇文献进行评价。
结果与结论：内镜下套扎与硬化治疗在控制急性出血和预防早期出血方面疗效确切，已经成为治疗食管胃底静脉曲张出血破裂出血的金标准。临床常用硬化剂包括5%鱼肝油酸钠、1%乙氧硬化醇、5%油酸氨基乙酸等。目前应用的组织胶均属α-氰丙烯酸酯类胶，在微量阴离子存在的情况下，能产生瞬间聚合反应而固化。硬化剂治疗时拔针后血管穿刺点会有出血现象，注射组织胶后可见曲张静脉向注射部位两侧增粗、发白，拔针后组织胶会封堵穿刺点而无渗血，即刻控制曲张静脉急性出血。内镜下治疗食管胃底静脉曲张破裂出血近期疗效显著，但远期疗效仍然是研究的重点。

关键词: 食管胃底静脉曲张, 经内镜, 套扎环, 硬化剂, 组织胶, 生物相容性

Abstract:

BACKGROUND: Currently, the efficacy of endoscopic sclerotherapy, endoscopic ligation and tissue glue embolization on esophageal varices has been recognized, but the differences in the efficacy of various methods exist.
OBJECTIVE: To elaborate the material characteristics and biocompatibility of ligation ring, tissue adhesive and sclerosant so as to investigate the therapeutic effects of endoscopic sclerotherapy, endoscopic ligation and tissue glue embolization on esophageal varices.
METHODS: An electronic search of CNKI (1989/2009) and Medline (1989/2009) databases was conducted to retrieve articles about biocompatibility of igation ring, tissue adhesive and sclerosant and their effects on esophageal varices. The keywords were “esophageal varices, ligation ring, sclerosant, tissue adhesive, therapy” in Chinese and “cerebrovascular disease, stent, therapy” in English. Repetitive articles, animal experiments and Meta analysis were excluded. Totally 17 articles were included.
RESULTS AND CONCLUSION: The efficacy of endoscopic ligation and sclerotherapy on the control of acute bleeding and prevention of early bleeding has been confirmed, which has become the god standard for esophageal varices bleeding. The common sclerostant includes 5% sodium cod liver oil, 1% ethyl alcohol sclerosis, 5% oleic acid and other amino acids. The current tissue adhesives belong to α-cyanide-acrylate glues, which can be solidified due to anion-induced polymerization reaction. Bleeding at the puncture site can be seen after needle injection during sclerotherapy. After tissue adhesive injection, acute bleeding can be controlled. The short-term effect of endoscopic treatment for esophageal varices bleeding is obvious, but the long-term effect still needs further studies.

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