辅助金属夹在内窥镜下组织胶注射治疗2型食管胃静脉曲张的胃底静脉曲张应用观察  

Application observation on assisted metal clip in the treatment of endoscopic tissue gel injection for gastric fundus varices of GOV2

作　　者：许朝 陈思 王松[1] 王慧群 贾勇 肖梅 XU Chao;CHEN Si;WANG Song(Department of Gastroenterology,The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001,China;不详)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)消化内科,安徽合肥230001

出　　处：《中国医学装备》2020年第9期99-102,共4页China Medical Equipment

基　　金：国家自然科学基金(81903096)“Circ RNA_102747/miR-221-3p/PTEN轴向调控胰腺癌吉西他滨化疗敏感性的机制研究”。

摘　　要：目的:探讨辅助金属夹在内窥镜下组织胶注射治疗伴食管静脉曲张的2型食管胃静脉曲张(GOV2)胃底静脉曲张的临床疗效及安全性。方法:选取16例行金属夹辅助组织胶注射治疗的GOV2胃底静脉曲张患者的病例资料,观察分析术中金属夹及组织胶使用量、胃底静脉曲张注射点数及术中拔针出血情况,以及治疗后曲张静脉改善、再出血以及并发症发生的情况,以及随访期内情况。结果:术中平均胃底静脉曲张注射点数(7.13±3.54)个,平均金属夹用量(1.69±0.60)个,组织胶用量(4.31±2.01)ml,术中拔针出血3例(占18.8%),均为针眼少量渗血可自行停止。术后1个月均行内窥镜下复查,胃静脉曲张改善达显效占75%(12/16),有效占18.8%(3/16),总体改善达93.8%(15/16);随访期内再出血1例(6.2%),表现为黑便,复查胃镜为排胶溃疡局部少量渗血;所有患者术后均未发生异位栓塞及严重术后并发症。结论:辅助金属夹在内窥镜下组织胶注射治疗GOV2胃底静脉曲张中有较好的疗效及安全性,其临床应用价值值得进一步研究。Objective: To investigate the clinical efficacy and safety of assisted metal clips in the treatment of endoscopic tissue gel injection for gastric fundus varices of the Type 2 gastroesophageal varices(GOV2) with esophageal varices. Methods: The data of 16 patients with GOV2 gastric fundus varices who underwent assisted metal clip in the treatment of endoscopic tissue gel injection were selected, and usage amount of metal clip and tissue gel, the number of injection point of gastric fundus varices and the situation of bleeding of withdrawing needle during operation were observed and analyzed. And the postoperative improvement of varices vein, recurrent bleeding, complication and the situation during follow-up period also were observed and analyzed. Results: During the operation, the average number of injection points of gastric fundus varices was(7.13±3.54), and the average amount of metal clip was(1.69 ±0.60), and the average amount of tissue glue was(4.31±2.01) ml, and 3 cases occurred bleeding in withdrawing needle and they were a little of exudation at needle point and could self-stop. They received reexamination under endoscope postoperative 1 month, the improvement of gastric fundus varices achieved 75%(12/16), and the valid of that achieved 18.8%(3/16), and the total improvement achieved 93.8%(15/16). 1 case was re-bleeding in followup period(6.2%), and the manifestation of patient was tarry stool, and the result of re-examination of endoscope was anabrosis with little exudation. And there were no allotopia embolism and seriously postoperative complication in all of patients. Conclusion: Assisted metal clip has favorable curative effect and safety in the treatment of endoscopic tissue gel injection for gastric fundus varices of GOV2 with esophageal varices. And its value is worth in further research of clinical application.

关 键 词：胃底静脉曲张 内窥镜下组织胶注射术 金属夹 安全性 疗效 

分 类 号：R573[医药卫生—消化系统]