식도 정맥류 출혈에 있어서 내시경적 경화료법의 치료효과
기춘석, 신현성, 주상언, 황흥곤, 이동후, 최일영, 박경남,
소속 상세정보
기춘석 ( Kee Choon-Suk )
한양대학교 의과대학 내과학교실
신현성 ( )
한양대학교 의과대학 내과학교실
주상언 ( Joo Sang-Un )
한양대학교 의과대학 내과학교실
황흥곤 ( Hwang Heung-Kon )
한양대학교 의과대학 내과학교실
이동후 ( Lee Dong-Hoo )
한양대학교 의과대학 내과학교실
최일영 ( Choi Il-Young )
한양대학교 의과대학 내과학교실
박경남 ( Park Kyung-Nam )
한양대학교 의과대학 내과학교실
KMID : 0614619830150010055
Abstract
Bleeding from esophageal varices is the most, severe complication in patients with cinhosis of the liver and portal hyrpertension. There has never been a uniform concept of emergency management of variceal bleeding because of pitfalls in the medical as well as the surgical therapeutic technics. Endoscopic injection sclerotherapy of esophageal varices is being reevaluated by many physicians because of increasing dissatisfaction with shunting procedures. This is to report the result of the EIS of 12 patients with esophageal varix. Who have been admitted to the department of internal medicine at Han Yang Universitv Hospital. The results are as follows: 1. 12 patients with liver cirrhosis who were proven to have esophaveal varices by esophagoscope were treated by EIS. There were 10 males and 2 females in the age range of 37 to 58 years. 2, Severity of liver cirrhosis was classified by Child method revealed cases in grade II and 7 cases in grade III, The varices were classified by the Sesoko method, revealed cases in moderate (B) and 8 cases in severe (C). Intravenous vasopressin was injected within 10 to 12 hours before EIS and b!ood transfusion was performed, if needed.
5.Solution of 5% sodium morrhuate was iniected into varices and Bovine thrombin was spraid around varices. 11 patients with active bleeding had control of their hemorrhage: 7 cases with first shooting, 3cases with second shooting, 1 case with third shooting. In the one patient without bleeding, esophageal varix was significantly decreased in size after EIS. 7. EIS has advantages such as simple, safe, inexpensive, low complication. 8. EIS is proposed as the emergency treatment of choice for patients with proven bleeding Esophageal varices who do not stop bleeding on conservative treatment.
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