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RISS 인기검색어
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- 저자 : 김병제(Byoung Jae Kim) (검색결과 1 건)
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식도 정맥류 출혈에 대한 내시경적 경화요법의 장기 관찰 결과
정정명(Jung Myung Chung),최하진(Ha Jin Choi),윤중근(Jung Kun Yoon),김병제(Byoung Jae Kim),박경태(Kyung Tae Park),김상정(Sang Jeong Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
N/A Esophageal Varices Bleeding is one of the major causes of death among the patients with liver cirrhosis or portal hypertenison, and it represents,50% mortality each episode of bleeding. As the method for the treatment of Esophageal Varices Bleeding, supportive cares such as Balloon tamponade, infusion of vasopressin are usually practiced but the results of therapy have been found unsatisfactory. Although surgical therapy can also be expected to improve the one-year survival rate, its long-term survival rate is very low because of high incidence of morbidity. For the purpose of improving these therapeutic defects, Endoscopic Injection Sclerotherapy has been tried as a new method and its good effects have been reported recently. Endoscopic Injection Sclerotherapy is so effective on the emergency treatment of Esophageal Varices Bleeding. However, it gives rise to many debates on the improvement of long-term survival rate. To investigate long-term prognosis of Endoscopic Injection Sclerotherapy, we evaluated the survival rates and the therapeutic effects on 150 patients with Esophageal Varices Bleeding, who were treated by Endoscopic Injection Sclerotherapv and could be followed up by the Department of Internal Medicine, In-Je Medical College. The results are as follow;. 1) Rebleeding occurred in,53 cases(35.3%) among patients followed up over one month after the first Endoscopic Injection Sclerotherapy. The incidence of rebleeding was highest within 6 months, noted in 23 cases (15.3%) which were 43.3% of all rebleedings. 2) Major complications of Injection Sclerotherapy were 6 cases of aspiration pneumonia. 4 cases of esophageal ulcer, 3 cases of esophageal stenosis, and of mediastinitis.Among all 16 cases fatal complications were estimated in cases. 3)During the follow up-period, 66 cases (44.0%) were expired. 26 cases (17.3%), which were 39.4% of all mortality, of expired cases were within one month after Sclerotherapy. The causes of their deaths were of hepatic failure in 35 cases(23.3%), of hepatoma in 16 cases (10.7%). of uncontrolled bleeding in 13 cases (8.7%), and of complications in 2 cases (1.3%). 4) The one-year survival rate of the patient afteer Sclerotherapy was 70.0%, and the four-years survival rate 40.0% (8 cases of 20 cases were survived). The survival rate of those patients was concerned with Child's Classicfication and remarkeable reduction in survival rate was noted in Child's class C. As the preceeding results, it isconsidered to be obvious that Endoscopic Injection Sclerotherapy is a recommendable method for the treatment and Esophageal Varices Bleeding. However, still high frequency of rebleeding and Hospital mortality are considered as projects to be improved hereafter.
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