内镜下胃底静脉曲张套扎术与组织胶注射术临床疗效回顾性分析  

Retrospective analysis on clinical curative effects of endoscopic gastric varices ligation and tissue adhesive injection

作　　者：彭伯坚[1] 张园[1] 张拥军[1] 张险峰 周永健[2] PENG Bojian;ZHANG Yuan;ZHANG Yongjun;ZHANG Xianfeng;ZHOU Yongjian(Department of Gastroenterology,Huadu District People's Hospital,Guangzhou 510800,China;Department of Gastroenterology,the People's Hospital of Guangzhou,Guangzhou 510180,China)

机构地区：[1]广州市花都区人民医院消化内科,广东广州510800 [2]广州市第一人民医院消化内科,广东广州510180

出　　处：《中国医药科学》2019年第7期245-248,共4页China Medicine And Pharmacy

摘　　要：目的探讨内镜下胃底静脉曲张套扎术与组织胶注射术临床疗效。方法选取2015年1月～2017年12月在我院进行治疗的胃底静脉曲张出血患者240例,采用随机数字表法将患者分为两组。套扎组行内镜下胃底静脉套扎术治疗120例;注射组行内镜下胃底静脉组织注射胶术治疗120例;以上患者均是胃底静脉曲张破裂出血住院患者,在48h内进行内镜下治疗,目的是止血,术后1、6个月复查胃镜,所有病例未做胃镜下二级预防性治疗,全部病例追踪随访。结果套扎组患者止血成功率(95.00%)高于注射组(88.33%),术后1月内及6月内的再出血率(5.00%、0)要低于注射组(6.67%、1.67%),套扎组患者胃底静脉曲张改善总有效率(94.17%)要高于注射组(87.50%),套扎组患者在术后发热、疼痛、异位栓塞、败血症及病死率(2.50%、3.33%、1.67%、4.17%、0)均要低于注射组(4.17%、6.67%、2.50%、5.83%、0.83%),上述所有指标两组比较差异无统计学意义(P> 0.05)。结论胃底静脉套扎组与胃底静脉组织胶注射组效果无差异,胃底静脉套扎治疗组无注射针眼出血情况,无排胶现象,止血成率高,且操作较简单,费用较低,操作风险较少,适推广。Objective To explore clinical curative effects of endoscopic gastric varices ligation and tissue adhesive injection. Methods Two hundred and forty patients with gastric varices bleeding who were treated in Huadu District People’s Hospital of Guangzhou from January 2015 to December 2017 were selected and they were divided into two groups by random number table method.120 patients in the ligation group underwent endoscopic gastric varices ligation while 120 patients in the injection group underwent endoscopic tissue adhesive injection in fundus venous tissues.The above patients were all hospitalized patients with gastric varices rupture and bleeding.They were treated with endoscopic therapy within 48 hours,with the purpose of hemostasis.Gastroscopy was reviewed in 1 month and 6 months after the operation and all the cases were not treated with secondary prophylactic treatment under gastroscopy.All the cases were followed up. Results The success rate of hemostasis in the ligation group(95.00%)was higher than that in the injection group(88.33%).The rates of rebleeding within one month and six months after operation(5.00%,0)in the ligation group were lower than those in the injection group(6.67%,1.67%).The total effective rate of gastric varices improvement in the ligation group(94.17%)was higher than that in the injection group(87.50%).Incidence of postoperative fever,pain,ectopic embolism,septicemia and mortality of patients(2.50%,3.33%,1.67%,4.17%,0)in the ligation group were all lower than those of the injection group(4.17%,6.67%,2.50%,5.83%,0.83%).There was no statistically significant difference in above indexes between the two groups(P > 0.05). Conclusion There was no difference in curative effects between endoscopic gastric varices ligation group and tissue adhesive injection in fundus venous tissue group.There is no injection needle hemorrhage and tissue adhesive discharge phenomenon.It has a high hemostasis rate,simple operation,low costs and less operation risks,so it is suitable for promotion.

关 键 词：内镜 胃底静脉曲张 套扎术 组织胶注射 并发症 

分 类 号：R571.3[医药卫生—消化系统]