肝硬化套扎联合硬化序贯治疗的疗效评价  

Efficacy evaluation of esophageal variceal ligation combined with endoscopic injection sclerotherapy sequential therapy

作　　者：徐衍 殷健[1] XU Yan;YIN Jian(Department of Gastroenterology,the First Affiliated Hospital of PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第四医学中心消化科,北京100048

出　　处：《武警医学》2018年第12期1138-1140,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨套扎联合硬化序贯治疗对肝硬化食管静脉曲张的疗效。方法选取医院2014-04至2017-04诊断为肝硬化并食管静脉曲张出血经过2次食管静脉曲张套扎治疗,食管静脉曲张内镜分级仍在中(G2)、重(G3)度的57例患者为研究对象,根据随机数字表法将受试者随机分为对照组(28例)和研究组(29例),研究组行套扎联合硬化序贯治疗,对照组继续行套扎序贯治疗。两组均在治疗后随访1年并复查胃镜,比较两组的序贯治疗次数、食管静脉曲张消除率、再出血发生率、并发症发生率。结果研究组食管静脉硬化术序贯治疗次数(2.24±0.95)少于对照组食管静脉套扎术序贯治疗次数(3.29±1.27),两组比较有统计学差异(P<0.05)。研究组静脉曲张消除率(89.66%)显著高于对照组(46.43%),再出血率(2.45%)低于对照组(14.29%),两组比较差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论套扎联合硬化序贯治疗可减少内镜下治疗次数,显著减少套扎术后残留的食管曲张静脉、延缓静脉曲张的复发,并发症风险无增加。Objective To explore the efficacy of esophageal vein ligation combined with endoscopic injection sclerotherapy sequential treatment of esophageal variceal bleeding in cirrhosis.Methods Fifty-seven patients with cirrhosis and esophageal variceal bleeding after twice esophageal variceal ligation,whose endoscopic grade of esophageal varices was still moderate(G2) and severe(G3),were selected between April 2014 and April 2017 as the subjects.Using the random number table method,these patients were divided into the control group of 28 cases and the study group of 29 cases.The study group was treated with EIS sequential therapy,while the control group continued to be treated with EVL sequential therapy.Both groups were followed up for one year after treatment and results of gastroscopy were reviewed.The number of times of sequential treatment、rate esophageal varice eradication,incidence of rebleeding,and incidence of complications were compared between the two groups.Results Sequential treatment was less frequent in the study group(2.24±0.95) than in the control group(3.29±1.27).The rate of esophageal varice eradication was(89.66%) in the study group,which was significantly better than that of the control group(46.43%),and the rate of rebleeding(2.45%) was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions EVL and EIS sequential therapy in the treatment of cirrhosis with esophageal variceal bleeding can effectively reduce the frequency of endoscopic treatment,mitigate residual esophageal varices after ligation,delay the recurrence of varicose veins,and without any increased risk of complications.

关 键 词：食管静脉套扎术 硬化剂疗法 肝硬化食管静脉曲张 

分 类 号：R657.31[医药卫生—外科学]