内镜下硬化剂联合组织胶治疗食管胃底静脉曲张76例疗效分析  

Efficacy analysis of 76 cases of esophagus and gastric varicose vein treated with sclerosing agent combined with tissue glue

作　　者：郭依心 李之印 叶月芳[2] 王敏[2] 郑蓓怡 蔡腾伟 GUO Yi-xin;LI Zhi-yin;YE Yue-fang;WANG Min;ZHENG Bei-yi;CAI Teng-wei(Department of Gustroenterology,the Third Hospital of Nanchang,Nanchang 330009,China)

机构地区：[1]南昌市第三医院消化内科,江西南昌330009 [2]杭州师范大学附属医院,浙江杭州311200

出　　处：《中国实用内科杂志》2021年第5期421-423,427,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家青年科学基金项目(81200284)。

摘　　要：目的探讨针对肝硬化食管胃底静脉中重度曲张需二级预防的患者,内镜下使用硬化剂联合组织胶仅注射于胃底曲张静脉的疗效及并发症情况。方法收集2015年1月至2016年9月杭州师范大学附属医院诊断为食管静脉与胃底静脉相通的肝硬化食管胃底静脉中重度曲张需二级预防,且在内镜下治疗的151例患者的临床资料。随机分为观察组(76例)和对照组(75例),观察组是内镜下使用硬化剂联合组织胶注射胃底曲张静脉,对照组使用硬化剂联合组织胶注射胃底曲张静脉+单纯硬化剂注射食管曲张静脉。术后比较两组的临床疗效及并发症情况。结果观察组在再出血率及食管狭窄方面与对照组无明显差异,两组差异无统计学意义(P>0.05)。在发热、胸骨后疼痛及食管溃疡发生率上,观察组明显低于对照组,差异有统计学意义(P<0.05)。两组疗效在总有效率方面相差不大,两组差异无统计学意义(P>0.05)。结论内镜下使用硬化剂联合组织胶治疗肝硬化食管胃底静脉曲张的患者时,两组方法效果相当,但仅注射于胃底静脉比注射食管+胃底静脉在并发症方面更有优势。Objective To investigate the efficacy and complications of endoscopic sclerosing agent combined with tissue glue injection into the gastric varices in patients with cirrhosis and severe esophageal and varices who need grade II prevention. Methods A collection of 151 patients with cirrhosis diagnosed in the Affiliated Hospital of Hangzhou Normal University from Jan. 2015 to Sep. 2016 with esophageal and fundus veins communicating with moderate and severe esophageal and fundus veins requiring secondary prevention and treatment under endoscopy clinical data. According to statistical methods,they were randomly divided into an observation group(76 cases)and a control group(75 cases). The observation group was endoscopically injected with sclerosing agent and tissue glue into the varicose vein,while the control group was using sclerosing agent and tissue glue. Injection into gastric varices + simple sclerosing agent injection into esophageal varices. The clinical efficacy and complications of the two groups were compared after operation. Results There was no significant difference between the observation group and the control group in terms of rebleeding rate or esophageal stenosis,and the difference between the two groups was not statistically significant(P>0.05). In the incidence of fever,retrosternal pain and esophageal ulcer,the observation group was significantly lower than the control group,and there were statistical differences(P<0.05). There was little difference in the total effective rate between the two groups,and the difference between the two groups was not statistically significant(P>0.05). Conclusion Endoscopic sclerosing agent combined with tissue glue in the treatment of patients with liver cirrhosis and esophagogastric varices,the two groups have equivalent results,but the injection just into the fundus vein has more advantage than the injection into esophagus +gastric undus in term of complications.

关 键 词：肝硬化 食管胃底静脉曲张 硬化剂 组织胶 多层螺旋CT门静脉血管成像 

分 类 号：R657.31[医药卫生—外科学]