经内镜组织胶注射治疗食管曲张静脉破裂出血患者临床观察  

Clinical study on endoscopic tissue glue injection for esophageal variceal vein rupture and bleeding

作　　者：魏伦收 任争 解淑萍 孙新房 WEI Lun-shou;REN Zheng;XIE Shu-ping;SUN Xin-fang(Department of Gastroenterology,Huaihe Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学淮河医院消化内科,河南开封475000

出　　处：《黑龙江医药科学》2021年第6期117-120,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省开封市科技发展计划项目,编号:1703024。

摘　　要：目的:探讨经内镜组织胶注射治疗食管曲张静脉破裂出血患者对其食管尾静脉曲张程度、出血情况及门静脉血栓的影响,为其临床治疗提供参考。方法:选择我院2017-05~2020-05收治的150例肝硬化食管曲张静脉破裂出血患者作为研究对象,按照治疗方式不同分为观察组和对照组两组,各75例。其中对照组患者给予常规保守治疗,观察组患者给予内镜组织胶注射联合套扎术治疗。1个月以后,进行胃镜复查,比较两组患者治疗前后的门静脉高压性胃病、红色征以及食管静脉曲张程度的变化;术后6个月的随访,观察比较两组患者的门静脉血栓、并发症、远期再出血、近期再出血、死亡率、胃底静脉曲张疗效以及临床疗效差异。结果:与治疗前相比,两组患者治疗后食管静脉曲张程度、红色征及门静脉高压性胃病均明显降低,且观察组患者降低更为显著(P<0.05)。治疗后观察组患者的远期再出血、并发症、死亡、门静脉血栓情况均明显低于对照组(P<0.05),两组患者治疗后近期再出血情况差异不显著(P>0.05)。观察组患者的胃底静脉曲张疗效和临床疗效分别为89.33%和90.67%,均明显高于对照组的74.67%和70.67%(P<0.05)。结论:经内镜组织胶注射治疗食管曲张静脉破裂出血患者可以明显降低术后再出血以及门静脉血栓情况的发生,减少术后并发症以及死亡率,改善静脉曲张程度,效果显著。Objective:To investigate the clinical efficacy of endoscopic tissue glue injection in the treatment of esophageal variceal vein rupture and hemorrhage.Methods:A total of 150 cirrhotic patients with esophageal variceal vein rupture and bleeding admitted to Huaihe Hospital of Henan University from May 2017 to May 2020 were selected as the research objects,and divided into observation group and control group according to different treatment methods,with 75 cases in each group.The control group was treated with conventional conservative treatment,and the observation group was treated with endoscopic tissue glue injection combined with ligation.After 1 month of treatment,the changes of portal hypertension gastropathy,red sign and esophageal varices were compared between the two groups before and after treatment.Six months after the operation,the two groups were followed up to compare the differences in portal vein thrombosis,complications,long-term rebleeding,short-term rebleeding,mortality,efficacy and clinical efficacy of gastric varicose veins.Results:Compared with before treatment,the degree of esophageal varices,red sign and portal hypertension gastropathy in two groups were significantly decreased after treatment,and the decrease was more obvious in the observation group(P<0.05).After treatment,the long-term rebleeding,complications,mortality and portal vein thrombosis in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in recent rebleeding after treatment between the two groups(P>0.05).The efficacy of fundus varices in the observation group(89.33%vs.74.67%)and clinical efficacy(90.67%vs.70.67%)were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Endoscopic tissue glue injection can significantly reduce the incidence of postoperative rebleeding and portal vein thrombosis,reduce postoperative complications,reduce mor

关 键 词：内镜组织胶注射 食管曲张静脉破裂出血 食管静脉曲张程度 门静脉血栓 

分 类 号：R571.3[医药卫生—消化系统]