内镜下组织黏合剂联合硬化剂注射治疗胃静脉曲张临床研究及随访  

Clinical study on endoscopic injection of tissue adhesive with hardener in treatment of gastric varices and follow-up

作　　者：张梦茵[1] 陈平[1] 袁晓琴[1] 蔡波尔 吴云林[1] ZHANG Mengyin;CHEN Ping;YUAN Xiaoqin;CAI Boer;WU Yunlin(Department of Gastroenterology,Ruijin Hospital(North),Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China)

机构地区：[1]上海交通大学医学院附属瑞金医院北部院区消化内科,上海201801

出　　处：《外科理论与实践》2022年第5期443-447,共5页Journal of Surgery Concepts & Practice

摘　　要：目的 :分析和随访内镜下组织黏合剂联合硬化剂注射治疗门静脉高压症胃静脉曲张的疗效及预后。方法:研究纳入2006年至2015年期间84例上消化道出血,胃镜检查显示胃静脉曲张,行内镜下组织黏合剂联合硬化剂注射治疗的病人,比较治疗前后出血频率,随访胃静脉曲张消除率及疾病转归。结果:84例病人内镜治疗共111例次,平均治疗(1.32±0.68)次/例。内镜治疗前出血(0.72±0.54)次/月,治疗后出血(0.30±0.82)次/月,两者比较差异有统计学意义(P<0.01)。内镜治疗后6个月内胃静脉曲张根除(基本消失)率为75.0%,治疗6个月后为70.8%。术后随访(14.82±19.30)个月内未发生再出血,术后无异位栓塞与感染并发症发生。结论:内镜下组织黏合剂联合硬化剂注射治疗有效降低胃静脉曲张出血频率,改善曲张静脉状态,是预防胃静脉曲张再出血的重要方法之一,可在临床应用推广。Objective To analyze the therapeutic effect of endoscopic injection of tissue adhesive combined with hardener for the portal hypertensive patients with gastric varicose and prognosis. Methods A total of 84 patients with upper gastrointestinal hemorrhage and gastric varices diagnosed by gastroscopy during 2006 to 2015, who were performed endoscopic injection with tissue adhesive with hardener, were included in this study. The rate of gastric hemorrhage was compared before and after endoscopic treatment. The rate of gastric varices elimination and the prognosis were analyzed.Results There were 111 times of endoscopic treatment for 84 cases with an average of(1.32±0.68) times per case. Bleeding was(0.72±0.54) times/month before treatment and(0.30 ±0.82) times/month after treatment respectively with significant difference statistically(P<0.01). The eradication rate of varicose veins with almost disappearance was 75.0% during the period of 6 months post endoscopic treatment and 70.8% after 6 months of endoscopic treatment. No re-bleeding was found without any complications, ectopic embolization and infection after follow-up of(14.82±19.30) months. Conclusions Endoscopic injection of tissue adhesive and hardener for gastric varices would reduce the rate of bleeding of gastric varicose and the varicose vein, which was an important procedure for prevention of re-bleeding of gastric varicose vein and could be applied clinically.

关 键 词：门静脉高压症 胃静脉曲张 内镜下治疗 组织黏合剂 硬化剂 

分 类 号：R657.34[医药卫生—外科学] R573[医药卫生—临床医学]