内镜下精准断流术治疗食管胃底静脉曲张的效果  

Efficacy of endoscopic selective varices devascularization in the treatment of esophageal and fundic varices

作　　者：苏有盛 招杰 严衍伟[1] 何艳婷 SU Yousheng;ZHAO Jie;YAN Yanwei;HE Yanting(Department of Gastroenterology,the First People’s Hospital of Zhaoqing,Guangdong,Zhaoqing 526000,China)

机构地区：[1]广东省肇庆市第一人民医院消化内科,广东肇庆526000

出　　处：《中国医药科学》2022年第7期192-195,共4页China Medicine And Pharmacy

基　　金：广东省肇庆市科技创新指导类项目(201804030718)。

摘　　要：目的探讨内镜下精准断流术在治疗食管胃底静脉曲张中的疗效。方法选取2018年6月至2020年6月肇庆市第一人民医院收治的食管胃底静脉曲张患者60例,入院时使用随机数字表法对患者进行编号,奇数者纳入观察组,偶数者纳入对照组。对照组患者接受传统序贯注射治疗,即食管静脉硬化+胃底组织胶三明治注射治疗,观察组患者接受内镜下精准断流术治疗。治疗结束后,记录两组患者的手术情况,包括注射次数、硬化剂使用量(聚桂醇+组织胶),并对所有患者进行至少1年随访,定期复查胃镜,观察曲张静脉消失或复发情况及术后并发症的发生情况。结果治疗后,观察组患者注射次数与硬化剂使用量均少于对照组患者,差异有统计学意义(P<0.05)。治疗后第6个月,观察组与治疗组的静脉曲张消失和再出血发生率比较,差异无统计学意义(P>0.05)。治疗后第12个月,观察组患者的静脉曲张消失率高于对照组,再出血发生率低于对照组,差异有统计学意义(P<0.05)。但两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论内镜下精准断流术在治疗食管胃底静脉曲张患者中疗效确切,与传统序贯注射治疗相比,不仅可以减少注射次数与药物剂量,降低患者痛苦,还能够有效减少静脉曲张复发和再出血,且安全性较高,不会增加发热、食管溃疡等常见并发症的发生率,值得推广应用。Objective To explore the efficacy of endoscopic selective varices devascularization(ESVD)in the treatment of esophageal and fundic varices(EFV).Methods A total of 60 patients with EFV admitted to the First People’s Hospital of Zhaoqing from June 2018 to June 2020 were selected and numbered at admission using the random number table method,with odd numbers included in the observation group and even numbers included in the control group.Patients in the control group received traditional sequential injection treatment,i.e.sandwich injection with tissue adhesive via the fundus of the stomach for esophageal vein sclerosis,while patients in the observation group received ESVD.At the end of treatment,the surgery situations of patients in both groups were recorded,including the number of injections and the amount of sclerosing agent(polidocanol+tissue adhesive)used.All patients were followed up for at least 1 year with regular re-examination by gastroscopy to observe the disappearance or relapse of varices and the occurrence of postoperative complications.Results At the end of treatment,the number of injections and the amount of sclerosing agent used in the observation group were less than those in the control group,with statistically significant differences(P<0.05).At the 6th month after the end of treatment,there were no statistically significant differences between the observation group and the treatment group in terms of the disappearance rate of varices and the incidence of rebleeding(P>0.05).At the 12th month after the end of treatment,the disappearance rate of varices in the observation group was higher than that in the control group,and the incidence of rebleeding was lower than that in the control group,with statistically significant differences(P<0.05).However,there was no statistically significant difference between the two groups in the incidence of complications(P>0.05).Conclusion ESVD is effective in the treatment of patients with EFV.Compared with traditional sequential injection treatment,it not only ca

关 键 词：胃底静脉曲张 电子胃镜 止血 精准断流术 复发 

分 类 号：R575.2[医药卫生—消化系统]