食管胃底静脉曲张破裂出血不同治疗方式疗效分析  

Clinical effi cacy of different treatment methods for the esophageal and gastric variceal bleeding

作　　者：王猛[1] 王启之[1] 燕善军[1] 汪建超[1] 薛永举[1] 赵义[1] Wang Meng;Wang Qizhi;Yan Shanjun(The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000)

机构地区：[1]蚌埠医学院第一附属医院

出　　处：《中国现代医药杂志》2019年第6期25-28,共4页Modern Medicine Journal of China

摘　　要：目的观察食管胃底静脉曲张破裂出血不同治疗方式的临床疗效。方法选取2016年1月~2017年9月就诊于我院的90例食管胃底静脉曲张破裂出血患者作为研究对象。根据不同治疗方式将患者平均分为3组,采用回顾性分析方式进行研究。只接受药物治疗的患者作为对照组;药物治疗后联合食管静脉曲张套扎术作为单纯套扎组;联合食管静脉曲张套扎术+硬化术作为联合治疗组。对3组患者的止血率、有效率、再出血率以及并发症情况进行分析。结果接受内镜下治疗的单纯套扎组和联合治疗组止血率、有效率均明显高于对照组,再出血率均明显低于对照组,差异有统计学意义(P<0.05);联合治疗组止血率(96.67%)稍高于单纯套扎组(93.33%),差异无统计学意义(P>0.05);联合治疗组有效率(93.33%)明显高于单纯套扎组(70.00%),差异有统计学意义(P<0.05);内镜下治疗术后常见并发症及治疗后3个月内再出血率方面,联合治疗组和单纯套扎组之间差异无统计学意义(P>0.05)。结论食管静脉曲张套扎联合硬化剂注射疗效肯定,值得推广应用。Objective To observe the clinical effect of different treatment methods for the esophageal and gastric variceal bleeding. Methods A retrospective analysis was performed on the clinical data of 90 cirrhotic patients with esophageal and gastric variceal bleeding in our hospital from Jan 2016 to Sep 2017. The patients were divided into 3 groups on average according to different treatment methods. Single drug conservative treatment was used in control group. Drug therapy followed by endoscopic variceal ligation was used in simple ligation group. Endoscopic variceal ligation combined with endoscopic variceal sclerotherapy was used in combination treatment group. The hemostatic rate, efficacy rate, rebleeding rate and the incidence of complications were compared among the three groups. ResultsHemostatic rate and efficacy rate of the simple ligation and combination treatment group were obviously higher than the control group, the rebleeding rate was significantly lower than the control group, the difference was statistically significant(P<0.05). The hemostatic rate of combination treatment group(96.67%)was slightly higher than simple ligation group(93.33%), the difference had no statistically significance(P>0.05). The efficacy rate of combination treatment group(93.33%)was obviously higher than simple ligation group(70.00%), the difference was statistically significant(P<0.05). The difference in postoperative complications and rebleeding rate of the simple ligation group and combination treatment group had no significance(P>0.05). Conclusion The endoscopic variceal ligation combined with variceal sclerotherapy in the treatment of esophagogastric variceal bleeding is effective and worthy of popularization and application.

关 键 词：肝硬化 食管胃底静脉曲张 静脉套扎 硬化剂治疗 

分 类 号：R575.2[医药卫生—消化系统]