有无门静脉血栓患者食管静脉曲张套扎术的疗效差异分析  

Comparison of Curative Effect of Esophageal Variceal Ligation in Patientswith or Without Portal Vein Thrombosis

作　　者：翟威 陈永忠[1] 仝亚林[1] ZHAI Wei;CHEN Yong-zhong;TONG Ya-lin(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450052

出　　处：《河南医学研究》2020年第36期6736-6739,共4页Henan Medical Research

摘　　要：目的分析内镜下食管静脉曲张套扎术(EVL)对肝硬化食管静脉曲张(EV)伴与不伴门静脉血栓(PVT)形成患者的疗效差异。方法回顾性分析2013年6月至2019年12月在郑州大学第一附属医院收治的181例因肝硬化食管静脉曲张(EV)行内镜下EVL治疗患者的临床资料,根据有无门静脉血栓将患者分为PVT组(35例)和无PVT组(146例)。比较两组EV消除的疗程次数、消除率,EV的复发时间、复发率,EV的再出血情况和急诊内镜止血成功率,分析EVL对不同类型PVT的疗效。结果PVT组EVL的中位疗程次数[3.0(2.3,4.0)]多于无PVT组[2.0(2.0,3.0)],差异有统计学意义(P<0.05)。PVT组的EV消除率(71.4%)与无PVT组(74.7%)比较,差异无统计学意义(P>0.05)。两组间EV的复发时间及复发率比较,差异无统计学意义(P>0.05)。PVT组治疗及随访期间再出血率(37.1%)高于无PVT组(20.5%),差异有统计学意义(P<0.05)。PVT组与无PVT组急诊EVL止血成功率均为100%。合并不同类型PVT患者接受EVL治疗后的消除率、复发率及再出血率比较,差异无统计学意义(P>0.05)。结论合并PVT的肝硬化患者经EVL消除EV需要更长的疗程,且在随访过程中再出血率高,但EV消除后,PVT并不影响EV的复发率和复发时间。Objective To analyze the clinical efficacy of endoscopic variceal ligation(EVL)in cirrhotic patients with esophageal varices(EV)with or without portal vein thrombosis(PVT).Methods The clinical data of 181 cirrhotic patients with EV who underwent EVL from June 2013 to December 2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Patients were divided into PVT group(35 cases)and non-PVT group(146 cases)according to whether there was PVT.The courses of EV elimination and elimination rate,the recurrence time and recurrence rate,rebleeding rate and success rate of emergency endoscopic hemostasis were compared between the two groups.Meanwhile,the curative effect of EVL on different types of PVT was analyzed.Results The median number of EVL courses[3.0(2.3,4.0)]were higher than non-PVT group[2.0(2.0,3.0)](P<0.05).The EV elimination rate between PVT group(71.4%)and non-PVT group(74.7%)had no statistical difference(P>0.05).There were no significant differences in the recurrence time and recurrence rate between two groups(P>0.05).The rate of rebleeding in PVT group(37.1%)was higher than non-PVT group(20.5%)in the period of treatment and follow-up(P<0.05).The success rates of emergency hemostasis in PVT group and non-PVT both were 100%.Then,there were no significant differences in the elimination rate,recurrence rate and rebleeding rate of patients with different types of PVT who accepted EVL(P>0.05).Conclusion Patients with PVT cirrhosis need longer course of EVL to eliminate EV,and the rate of rebleeding is high during follow-up,but after EV elimination,PVT does not affect the recurrence rate and recurrence time of the EV.

关 键 词：肝硬化 门静脉血栓 内镜下食管静脉曲张套扎术 

分 类 号：R571.3[医药卫生—消化系统]