皮圈套扎治疗1型胃食管静脉曲张出血61例的多中心临床研究  

Muiticenter clinical study of endoscopic variceal ligation in the treatment of 61 cases of type 1 gastroesophageal varices bleeding

作　　者：李会贤[1] 马超[2] 张丽瑶[3] 孔德润[1] Li Huixian;Ma Chao;Zhang Li yao;Kong Derun(Department of Gastroenterology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院消化内科,合肥230022 [2]阜阳市第二人民医院消化内科 [3]沈阳市第六人民医院重症医学科

出　　处：《中华消化杂志》2018年第10期669-672,共4页Chinese Journal of Digestion

摘　　要：目的探讨胃镜下静脉曲张套扎术（EVL）治疗1型胃食管静脉曲张（GOV1型）的疗效。方法回顾性分析2016年7月至2017年5月于安徽医科大学第一附属医院、阜阳市第二人民医院和沈阳市第六人民医院行EVL治疗的GOV1型胃底静脉曲张患者的治疗效果，观察并统计胃底静脉曲张套扎环数、急诊（出血24 h内）止血、止血成功、早期（术后72 h至6周）再出血、迟发性（术后6周）再出血及胃底静脉曲张基本消失的情况。随访6～16个月，评估EVL术后并发症。结果61例GOV1型患者中，男40例，女21例，年龄为（50.9±10.9）岁。EVL中套扎1～6点，平均（3.8±1.9）点。7例活动性出血患者均成功实现急诊止血；术后72 h内有1例发生再出血，止血成功率为98.3%（60/61）；早期再出血率为11.5%（7/61），迟发性再出血率为4.9%（3/61），总再出血率为16.4%（10/61）。胃底静脉曲张基本消失率为85.2%（52/61）。并发症发生率为21.3%（13/61），所有患者均无溃疡后出血、自发性腹膜炎和穿孔发生。结论EVL能有效控制GOV1型患者胃底静脉曲张急性出血，术后再出血率和并发症发生率低，静脉曲张消失率高。ObjectiveTo investigate the clinical efficacy of endoscopic variceal ligation （EVL） in the treatment of type 1 gastroesophageal varices （GOV1）.MethodsFrom July 2016 to May 2017, at the First Affiliated Hospital of Anhui Medical University, NO.2 People′s Hospital of Fuyang City and the Sixth People′s Hospital of Shenyang, the efficacy of EVL in the treatment of patients with GOV1 were retrospectively analyzed. The number of ligation rings, emergency （bleeding within 24 hours） hemostasis, successful hemostasis, early rebleeding （from 72 hours to six weeks after operation）, delayed rebleeding （at six weeks after operation） and disappearance of gastroesophageal varices were observed. Patients were followed up for six to 16 months and postoperative complications of EVL were evaluated.ResultsThere were 61 patients with GOV1 （40 males and 21 females）, and the mean age was （50.9±10.9） years. The number of ligation during EVL operation was one to six （mean 3.8±1.9）. Seven patients with active bleeding were all successfully achieved emergency hemostasis. One case had rebleeding in 72 hours after operation, and the hemostatic rate was 98.3% （60/61）. The early rebleeding rate was 11.5% （7/61）, the delayed rebleeding rate was 4.9% （3/61）, and the total rebleeding rate was 16.4% （10/61）. The disappearance rate of gastroesophageal varices was 85.2% （52/61）. The complication rate was 21.3% （13/61）. No post-ligation ulcer bleeding, spontaneous bacterial peritonitis and perforation were observed in all patients.ConclusionsEVL can effectively control the acute hemmorrhage of GOV1 type gastric varices. The postoperative rebleeding rate and complication rate are low. However, the disappearance rate of varices is high.

关 键 词：食管和胃静脉曲张 多中心研究 回顾性研究 内镜治疗 套扎术 

分 类 号：R575.2[医药卫生—消化系统]