간경변증의 상태와 식도정맥류의 정도가 식도정맥류 결찰요법에 미치는 영향

Abstract

EVL is a newly developed alternative technique to sclerotherapy. This technique consists of mechanical ligation and thrombosis of varices using elastic "O" rings. Fifty-seven bleeding patients were selected for evaluation. These patients had varices that were eradicated by EVL. They were analysed based on the severity of varices and liver cirrhosis that affected eradication of varices. We compared the ligation time and the number of bands used for eradication of varices. 1. Among 57 liver cirrhosis patients, 33 (58%) patients were due to alcoholics, while 24 (42%) patients were due to postviral infection. According to Child- Pugh classification, 16 (28%) patients were A, 32 (56%) patients B, and 9 (16%) patients C. 2. The severity of varices is classified by grade (G) and location (L) as follows: Five patients with G2 (varix diameter between 4-6 mm), 28 with G3(7-10mm), and 24 with G4 (over 10mm) ; 5 patients with L1 (inferior), 34 with L2 (inferior and middle), and 18 with L3 (entire portion). 3. The ligation time and the number of bands used for eradication of varices by grade were 2.2 and 5.6 for G2 and G3, and 2.8 and 9.0 for G4 respectively. 4. The ligation time and the number of bands used for eradication of varices by location were 1.6 and 3.2 for L1, 2.3 and 6.3 for L2, 3.0 and 9.4 for L3 respectively. 5. According to Child-Pugh classification, the ligation time and the number of bands used for eradication were not significantly different. In conclusion, the ligation time and the number of bands used for eradication of varices were increased as the size of varix and location of the lesion became more involved. However, the severity of cirrhosis did not affect procedures.