内镜下金属夹联合多项方法治疗食管胃底静脉曲张破裂出血的疗效评价研究  

Efficacy evaluation study of treatment on esophageal and gastric variceal bleeding by endoscopic metal clips combined with multiple methods

作　　者：冯刚 饶正伟 陈琛 付谦 李琴 姚哲 庹必光 FENG Gang;RAO Zhengwei;CHEN Chen;FU Qian;LI Qin;YAO Zhe;TUO Biguang(Department of Gastroenterology,Bozhou District People′s Hospital of Zunyi City,Zunyi,Guizhou 563100,China;Department of Gastroenterology,Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563003,China)

机构地区：[1]遵义市播州区人民医院消化内科,贵州遵义563100 [2]遵义医科大学附属医院消化内科,贵州遵义563003

出　　处：《现代医药卫生》2020年第18期2877-2880,共4页Journal of Modern Medicine & Health

基　　金：贵州省卫生健康委员会科学技术基金项目(gzwjkj2016-1-074)。

摘　　要：目的探讨内镜下使用金属夹联合硬化、栓塞及套扎等多项方法治疗食管胃底静脉曲张破裂出血(EGVB)的临床疗效。方法选取2014年2月至2018年12月遵义市播州区人民医院消化内科收治的EGVB患者78例,均分为内镜下金属夹联合硬化、栓塞及套扎联用内科药物治疗组(联合治疗组,39例)和单纯内科药物治疗组(对照组,39例),收集患者临床资料(止血有效率,近期再出血率、远期再出血率,病死率、住院时间及住院费用等)并比较。结果联合治疗组EGVB患者的住院时间及住院费用均明显低于对照组,差异均有统计学意义(P<0.01);联合治疗组EGVB患者止血有效率明显高于对照组,但近期再出血率、远期再出血率及病死率均低于对照组,差异均有统计学意义(P<0.05)。结论内镜下金属夹联合硬化、栓塞及套扎联用内科药物治疗EGVB,疗效好,可降低再出血风险,降低患者病死率,缩短患者住院时间,减少患者住院费用,优于单纯内科药物治疗,值得基层医院推广。Objective To explore the clinical efficacy of endoscopic metal clips combined with sclerosis,embolization and ligation,ect.in the treatment of esophagogastric varices bleeding(EGVB).Methods Seventy-eight patients with EGVB admitted to the Gastroenterology Department of Bozhou District People′s Hospital of Zunyi City from February 2014 to December 2018 were selected and divided into endoscopic metal clip combined with sclerotherapy,embolization and variceal ligation and medical drug treatment group(combined treatment group,39 cases)and medical drug treatment group(control group,39 cases),collecting and comparing clinical data of patients(effective rate of hemostasis,recent rebleeding rate,long-term rebleeding rate,mortality rate,hospitalization time and hospitalization cost,etc.).Results The hospitalization time and hospitalization costs of patients with EGVB in the combined treatment group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).The effective rate of hemostasis of patients with EGVB in the combined treatment group was significantly higher than that in the control group,but the recent rebleeding rate,long-term rebleeding rate and mortality rate of the patients with EGVB in the combined treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Metal clips combined with sclerosis,embolization and ligation combined with medical drugs for the treatment to EGVB have a good effect,which can reduce the risk of rebleeding,reduce the mortality of patients,shorten the length of hospital stay,and reduce the cost of hospitalization.It is superior to medical medicine alone,and which is worth promoting in primary hospital.

关 键 词：内镜 金属夹 硬化剂 组织胶 注射 套扎 食管胃底静脉曲张 出血 

分 类 号：R571.3[医药卫生—消化系统] R573.2[医药卫生—内科学]