胃镜下硬化剂和组织胶治疗胃静脉曲张破裂出血比较研究  

Comparison study of the therapeutic effects of sclerosing agent and tissue glue under gastroscope on rupture hemorrhage of gastric varicosity

作　　者：贾彦生[1] 崔美兰[1] 康海燕[1] 赵子龙[1] 金鹏[1] 殷树英[1] JIA Yansheng;CUI Meilan;KANG Haiyan(The Fifth Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市第五医院,050021

出　　处：《河北医药》2020年第8期1224-1226,1230,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划(编号:111461563)。

摘　　要：目的探讨胃镜下硬化剂和组织胶治疗胃静脉曲张破裂出血的疗效。方法回顾性研究2012年1月至2016年12月收治的胃静脉曲张破裂出血并进行内镜下治疗患者105例,按照治疗方法不同分为硬化剂组(n=44)和组织胶组(n=61)。比较2组患者止血成功率、早期再出血率以及迟发性再出血率和静脉曲张根除率的差别,同时对术后发热、胸痛、溃疡等常见的并发症进行对比,进而对这两种方法的疗效进行对比分析。结果硬化剂组44例,胃镜下可见活动性出血23例,成功止血17例,不能止血6例,其中5例追加组织胶后止血,1例三腔两囊管压迫无效死亡;去除追加组织胶的5例患者和1例死亡患者后的全部38患者随访至少1年,硬化剂治疗后6周内再出血9例,6周~1年内再出血15例;治疗后胃镜随访,1年内胃静脉曲张根除8例。组织胶组61例,活动性出血41例,止血38例,3例未能止血,采用三腔两囊管压迫后全部无效死亡;除去死亡的3例以后的58例患者随访至少1年,早期再出血4例,迟发性再出血7例;治疗后胃镜随访,1年内胃静脉曲张根除51例。2组患者止血成功率和早期再出血率差异无统计学意义(P>0.05),2组患者迟发性再出血和静脉曲张根除率差异有统计学意义(P<0.05)。结论硬化剂治疗肝硬化门静脉高压胃静脉曲张破裂出血的急诊止血成功率以及早期再出血率和组织胶治疗相似,硬化剂治疗的迟发性再出血率高于组织胶治疗,静脉曲张根除率低于组织胶治疗,两种治疗方法的并发症发生率没有差别。Objective To investigate the therapeutic effects of sclerosing agent and tissue glue under gastroscope on rupture hemorrhage of gastric varicosity.Methods The clinical data about 105 patients with rupture hemorrhage of gastric varicosity who were admitted and treated under gastroscope in our hospital from January 2012 to Descember 2016 were retrospectively analyzed,who were divided into sclerosing agent group(n=44)and tissue glue group(n=61)according to the different therapeutic methods.The hemostasis success rate,early phase rebleeding rate,tardive rebleeding rate and the eradication rate of varicosity were observed and compared between the two groups.Results Among the 44 cases in sclerosing agent group,there were 23 cases of active bleeding that were visible under gastroscope,17 cases of successful hemostasis,and 6 cases failed to hemostasis,of whom,5 cases stopped bleeding after givening tissue glue,and 1 case died due to three lumens and two cystic tubes invalid compression.Within 6 weeks after sclerosing agent treatment,there were 9 cases of rehaemorrhagia,and there were 15 cases of rehaemorrhagia during 6week^1year.After treatment the patients were followed up,there were 8 cases of gastric varicosity eradication witin one year.Among 61 cases in tissue glue group,there were 41 cases of active bleeding,38 cases stopped bleeding successfully,and 3 cases failed to hemostasis and died due to three lumens and two cystic tubes invalid compression.After treatment,except for 3 cases of death,the other 58 patients were followed up at least one year,of whim,there were 4 cases of early phase rebleeding,and 7 cases of tardive rebleeding,and 51 cases of gastric varicosity eradication within 1 year.There were no significant differences in hemostasis success rate and early phase rebleeding rate between the two groups(P>0.05).However there were significant differences in tardive rebleeding rate and the eradication rate of varicosity between the two groups(P<0.05).Conclusion The hemostasis success rate of emergency treatment

关 键 词：硬化剂 组织胶 胃静脉曲张 胃镜 

分 类 号：R571.3[医药卫生—消化系统]