中国内镜杂志2026，Vol.32Issue(3)：51-57,7.DOI:10.12235/E20250458
内镜序贯治疗儿童门静脉高压症伴食管胃静脉曲张破裂出血的疗效观察
Efficacy of endoscopic sequential therapy for esophagogastric variceal bleeding in pediatric portal hypertension
董倩倩 1李文波 1王明辉 1李群 1范飞飞 1王静 1李灵敏 1孙奎林 1刘晓峰1
作者信息
- 1. 解放军联勤保障部队第九六〇医院 消化科,山东 济南 250031
- 折叠
摘要
Abstract
Objective To evaluate the clinical efficacy of sequential endoscopic treatment for children with portal hypertension(PHT)accompanied by esophagogastric variceal bleeding(EVB).Methods A retrospective analysis was conducted on 21 children with PHT accompanied by EVB who received sequential endoscopic treatment in this hospital from June 2010 to February 2023.The medical history,endoscopic manifestations,efficacy,and postoperative growth and development of the children were collected,and the required number of endoscopes,immediate hemostasis rate,rebleeding rate,postoperative complications,postoperative survival rate,and long-term growth and development were analyzed.Results The average age of the patients was(6.86±2.95)years.The hemoglobin level before the last treatment was significantly higher than that at the first admission,and the difference was statistically significant(P<0.01).81 endoscopic treatments(105 sessions)were performed,and the median number of treatments received by 21 patients were 4.00(1.00,10.00)times.Among them,18 patients received endoscopic ligation treatment,and the number of ligation rings in each case was 7.00(6.00,12.00)rings.Eighteen cases were treated with endoscopic injection sclerotherapy(EIS),and the dosage of sclerosing agent for each case was(12.29±5.67)mL.Nineteen cases were treated with endoscopic tissue adhesive injection,and the dosage of tissue adhesive for each case was(2.96±1.24)mL.The immediate hemostasis rate under endoscopy was 100.00%.The rebleeding rate within 6 months was 4.76%(1/21),and the rebleeding rate after 6 months was 14.28%(3/21).By the end of the follow-up,4 children had reached adulthood,and their body mass index(BMI)was all within the normal range.The weight for age Z score(WAZ)of the remaining 17 underage children improved significantly(P<0.01).Conclusion Endoscopic sequential treatment of PHT with EVB in children is safe and effective.While promoting the growth and development of children,it can also serve as a remedial measure after surgical operation and provide surgical or liver transplantation opportunities for those who have not undergone surgery.关键词
食管胃静脉曲张破裂出血(EVB)/儿童/内镜/序贯治疗/门静脉高压症(PHT)Key words
esophagogastric variceal bleeding(EVB)/children/endoscopy/sequential therapy/portal hypertension(PHT)分类
医药卫生引用本文复制引用
董倩倩,李文波,王明辉,李群,范飞飞,王静,李灵敏,孙奎林,刘晓峰..内镜序贯治疗儿童门静脉高压症伴食管胃静脉曲张破裂出血的疗效观察[J].中国内镜杂志,2026,32(3):51-57,7.
