内镜下密集套扎术联合血凝酶局部注射治疗食管胃底静脉曲张出血的疗效  

Outcomes of combined use of dense endoscopic variceal ligation and local injection of hemocoagulase in treating esophageal and gastric variceal bleeding

作　　者：章维[1] 张苗尊 李建阳[1] 

机构地区：[1]宁波市第二医院消化病科,浙江省315010 [2]宁波市鄞州人民医院肝胆外科

出　　处：《江苏医药》2013年第8期915-917,共3页Jiangsu Medical Journal

摘　　要：目的探讨内镜下密集套扎术(DEVL)联合血凝酶治疗食管胃底静脉曲张出血(EGVB)的疗效。方法 60例EGVB患者均分为两组:A组给予DEVL联合血凝酶1kU局部注射治疗;B组给予单纯DEVL治疗。末次内镜治疗后3、6个月复查胃镜,评价临床疗效,记录术后并发症。结果 A组急性活动性出血控制率为100%,静脉曲张根治率为90.0%,明显高于B组的70.0%和66.7%(P<0.01和P<0.05)。A组近期再出血率为10.0%,远期再出血率为13.3%,明显低于B组的50.0%和40.0%(P<0.01和P<0.05)。A组并发症发生率为20.0%,显著低于对照组的83.3%(P<0.05)。A组术后无死亡病例;B组死亡4例(13.3%)。结论 DEVL联合局部注射血凝酶治疗EGVB临床疗效优于单纯DEVL治疗。Objective To investigate the clinical efficacy of treating esophageal and gastric variceal bleeding （EGVB） by combined use of dense endoscopic variceal ligation（DEVL） and local injection of hemocoagulase 1 kU. Methods Sixty EGVB patients were treated by DEVL and hemocoagulase injection （group A, 30 cases） and by DEVL alone（group B, 30 cases）. The efficacy and complications were followed up lby gastroendoscopy in the 3rd and 6th month after the last treatment. Results The hemostatic success rate and the elimination rate of varicose veins in group A were 100% and 90. 0%, respectively, which were higher than 70. 0% and 66.7% in group B（P〈0. 01 and P〈0. 05）. The rates of short-term and long-term rebleeding in group A were 10. 0% and 13. 3%, respectively,which were lower than 50. 0% and 40.0% in group B（P〈0. 01 and P〈0. 05）. The incidence rate of postoperative complications in group A was 20. 0%,which was lower than 83.3% in group 15（P〈0. 05）. There was no death case in group A. Four（13.3%） cases were dead in group 15. Conclusion Combined use of DEVL and hemocoagulase injection therapy is better than DEVL alone in the treatment of patients with EGVB.

关 键 词：食管胃底静脉曲张出血 内镜下密集套扎 血凝酶 

分 类 号：R575[医药卫生—消化系统]