内镜下两种套扎法治疗食管静脉曲张的临床研究  

Clinical study on two endoscopic ligation methods in treatment of esophageal varices

作　　者：彭亚诗 李雪[1] 张磊[1] 杨刚[1] 缪佳蓉[1] 谭英[1] 南琼[1] PENG Yashi;L I Xue;ZHANG Lei;YANG Gang;MIAO J iarong;TAN Ying . NAN Qiong(Department of Gastroenterology, the First Affiliated Hospital Of Kunming Medical University/Yunnan Institute of Digestive Diseases, Kunming ,Yunnan 650032, Chin)

机构地区：[1]昆明医科大学第一附属医院消化内科/云南省消化疾病研究所,650032

出　　处：《重庆医学》2018年第16期2170-2172,共3页Chongqing medicine

基　　金：云南省教育厅科学研究基金重点项目(2015Z071)

摘　　要：目的观察内镜下密集套扎和非密集套扎疗法治疗食管静脉曲张的效果。方法选取2007-2013年该院收治的伴有肝硬化并食管静脉曲张患者89例,观察组39例采用密集套扎,对照组50例采用非密集套扎。采用6连发套扎器行内镜下治疗。以1次套扎圈大于6个且小于或等于12个为密集套扎,套扎圈小于或等于6个为非密集套扎,比较两组疗效。结果观察组首次平均套扎次数高于对照组,差异有统计学意义(t=29.11,P=0.000);观察组治愈率高于对照组,差异有统计学意义(χ~2=5.002,P=0.025);两组首次有效率比较,差异无统计学意义(χ~2=2.268,P=0.132)。观察组半年、1年、2年、3年后复查总有效率高于对照组,差异有统计学意义(P<0.05)。结论食管静脉曲张采用密集套扎法治疗,静脉曲张消失率高,能减少平均套扎次数,患者术后恢复良好,远期治愈情况较好,是临床治疗食管静脉曲张的可靠方法。Objective To compare the clinical efficacy of endoscopic ligation between using intensive ligation and non-intensive ligation methods for severe esophageal varices.Methods A total of 89 patients with cirrhosis and esophageal varices in our hospital from 2007 to 2013 were selected and divided into two groups.Patients in the observation group were treated with endoscopic ligation using intensive ligation（39 cases）,and patients in the control group were treated with endoscopic ligation using non-intensive ligation（50 cases）.Sixshooter multi-band ligator was used for endoscopic therapy.If the number of loop ligature collar was larger than 6 and less than or equal to 12,it was regarded as intensive ligation;if the number of loop ligature collar was smaller or equal to 6,it was regarded as non-intensive ligation.The clinical efficacy was compared between the two groups.Results The average number of ligation in the observation group was greater than that in the control group,there was statistically significant difference（t=29.11,P=0.000）.The cure rate at the first time in the observation group was higher than that in the control group,there was statistically significant difference（χ2=5.002,P=0.025）.No statistically significant difference was found in efficient rate at the first ligation（χ2=2.268,P=0.132）.The total effective rates in the observation group half a year,one year,two years and three years after operation was significantly higher than those in the control group（P〈0.05）.Conclusion Intensive ligation is a safe,reliable and effective approach for esophageal varices,which could have a high effective rate in the treatment of esophageal varices and reduce the average number of ligation,patients recover well after surgery and have a good long-term prognosis.

关 键 词：肝硬化 食管静脉曲张 内镜静脉曲张结扎 

分 类 号：R571[医药卫生—消化系统]