五倍子治疗食管静脉曲张的病理机制和临床效果

摘要

目的研究五倍子注射液治疗食管曲张静脉的病理机制和临床效果。方法随机对40只肝前性门脉高压伴食管静脉曲张的新西兰兔经食管曲张静脉内和(或)旁注射生理盐水和50%、75%、100%五倍子液，同时对34例肝硬化门脉高压食管胃底曲张静脉破裂出血者，经纤维胃镜施行75%五倍子注射液注射治疗。结果第8天后50%、75%、100%五倍子组食管溃疡分别为0%、8%、33%；其组织学特征为"凝固性坏死"，与注射浓度有关。临床应用后再出血率21%(7/34)，曲张静脉总改善率55%(12/22)，5年生存率为70%，Child A、B级和Child C级分别为86%和50%。结论五倍子注射液能产生较理想的病理反应，临床使用疗效高，并发症少。因而有临床推广应用价值。%Objective　 To study pathologic mechanism and clinical effect of Chinese Gall extraction in the treatment of esophageal varices.　Methods　 40 New Zealand rabbits with prehepatic portal hypertension and esophageal varices were randomly subject to injection of NS and 50%,75%,100% Chinese Gall extraction respectively intra-and/or para-varices.The histologic feature is coagulation necrosis,and the extent of collapsing was directly proportional to injection concentration.34 cases with bleeding history caused by esophageal and gastric varices were treated with injection of 75% Chinese Gall solution by endoscopy.　Results　 At the 8th day,the esophageal ulceration rate was 0% in 50% solution group, 8% in 75% group, and 33% in 100% group. Clinically the rebleeding rate was 21%(7/34),varices imporvement was 55%(12/22). 5-year survival rate was 70%, that of Child A、B and C were 86% and 50%,respectively.　Conclusions　 Chinese Gall solution induces ideal pathologic change effective to treat and prevent variceal bleeding.