无痛胃镜下序贯治疗食管胃底静脉曲张的疗效与安全性评价  

Evaluation of efficacy and safety of sequential treatment on esophagogastric varices under painless gastroscopy

作　　者：霍红[1] 吴贵恺[1] 刘国祥[1] 朱福涛[1] 徐京丽[1] 张晓君[1] 司雁菱[1] 

机构地区：[1]河北省唐山市工人医院消化内科,063000

出　　处：《中华消化病与影像杂志（电子版）》2012年第5期5-8,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的评价无痛胃镜下食管胃底静脉曲张长间隔序贯治疗的远期疗效及安全性。方法选取河北省唐山市工人医院2006年1月至2009年1月收治的经消化内镜证实的肝硬化食管胃底静脉曲张患者（镜下分级为F2-F3级）240例，按随机数字表法均分为2组。治疗组120例，应用无痛胃镜下食管胃底曲张静脉长间隔（1个月）套扎硬化序贯治疗；对照组120例，行普通内镜下一般间隔（2周）套扎治疗。2组患者镜下曲张静脉根除（镜下分级达FD级）均结束治疗。治疗结束后继续随访观察24个月。采用χ^2检验比较治疗组与对照组静脉曲张复发率、再出血率、并发症发生率差异。结果治疗组静脉曲张复发率、再出血率、并发症发生率分别为8．3％（10／120）、1．6％（2／120）及5．0％（6／120），均低于对照组的26．6％（32／120）、7．5％（9／120）、12．5％（15／120），且差异均有统计学意义（χ^2=13．968，4．668，4．227；均P〈0．05）。结论无痛胃镜下食管胃底曲张静脉长间隔序贯治疗具有良好的远期疗效及安全性。Objective To evaluate long-term efficacy and safety of sequential treatment on esophagogastric varices under painless gastroscopy. Methods Totally 240 hepatic cirrhosis patients admitted to Tangshan Gongren Hospital of Hebei Province, from January, 2006 to Janum-y, 2009 complicating with esophagogastric varices （endoscopic grade F2-F3） were enrolled in the research. The patients were randomly divided into two groups： treatment group（n = 120） received sequential therapy of ligation and sclerotherapy under painless gastroscopy with an interval of one month; control group （n = 120） received routine treatment, i. e. ligation under gastroscopy with a shorter interval of two weeks. Treatment ending in each group was the eradication of varices （endoscopic grade F0）. All patients were followed in the next 24 months. Recurrence of varices, rehemorrhagia rate and incidence of complication in both groups were recorded. Results The recurrence rate of varices, rehemerrhagia rate and incidence of complication in the treatment group were significantly lower than those in the control group[8.3% （10/120） vs 26.6% （32/120）, 1.6% （2/120） vs 7. 5% （9/120）, 5.0% （6/120） vs 12. 5% （15/120）, χ^2 = 13. 968,4. 668,4. 227;all P 〈 0. 05 ]. Conclusion The long-term clinical efficacy and safety of sequential treatment of esophagogatric varices under painless gastroscopy with one-month interval are better than those of the routine treatment.

关 键 词：食管和胃静脉曲张 硬化疗法 胃镜 

分 类 号：R575.2[医药卫生—消化系统]