内镜治疗食管胃底静脉曲张破裂出血的效果  

Efficacy of endoscopic treatment of esophageal-gastric fundus variceal bleeding

作　　者：李安全 周小微 陈嘉明 刘世滢 LI Anquan;ZHOU Xiaowei;CHEN Jiaming;LIU Shiying(Department of Gastroenterology,Nanping First Hospital Affiliated to Fujian Medical University,Fujian,Nanping 353000,China;Department of Laboratory Medicine,Nanping First Hospital Affiliated to Fujian Medical University,Fujian,Nanping 353000,China;Department of Gastroenterology,Wuyishan Municipal Hospital,Fujian,Wuyishan 354300,China)

机构地区：[1]福建医科大学附属南平第一医院消化内科,福建南平353000 [2]福建医科大学附属南平第一医院检验科,福建南平353000 [3]福建省武夷山市立医院消化内科,福建武夷山354300

出　　处：《中国医药科学》2022年第23期173-177,共5页China Medicine And Pharmacy

基　　金：福建省自然科学基金资助项目(2021J011424);福建医科大学启航基金项目(2020QH1296)。

摘　　要：目的 内镜止血被认为是治疗非静脉曲张性上消化道出血的一种更有效的常规药物治疗方法。然而,内镜止血治疗食管静脉曲张出血的有效性仍不确定。本研究回顾性研究内镜治疗食管胃底静脉曲张破裂出血的效果及安全性。方法 选取2017年7月至2021年1月福建医科大学附属南平第一医院收治的95例食管胃底静脉曲张破裂出血初次住院患者作为研究对象。采用回顾性研究,根据治疗方法不同分为对照组(n=30)和内镜治疗组(n=65),其中内镜治疗组包括单纯套扎组(n=25)、联合治疗组(n=40)。统计分析3组止血总有效率、病死率、止血时间、再出血率及并发症发生率。结果 单纯套扎组、联合治疗组止血总有效率均显著高于对照组,差异有统计学意义(P <0.05)。单纯套扎组、联合治疗组不同时间的止血有效率均显著高于对照组,差异有统计学意义(P <0.05)。单纯套扎组、联合治疗组1年内再出血率显著低于对照组,差异有统计学意义(P <0.05)。联合治疗组与单纯套扎组2周内、8周内、1年内再出血率比较,差异无统计学意义(P> 0.05)。内镜治疗并发症总发生率比较,差异无统计学意义(P> 0.05)。结论 与内科保守治疗相比,内镜治疗食管胃底静脉曲张破裂出血治愈率较高,具有再出血率低、并发症少等优点,另一方面,内镜治疗较安全且易于掌握。可在食管胃底静脉曲张破裂出血患者的临床实践中大规模推广应用。Objective Endoscopic hemostasis is considered to be a more effective conventional pharmacological treatment for non-variceal upper gastrointestinal bleeding. However, the efficacy of endoscopic hemostasis in the treatment of esophageal variceal bleeding remains uncertain. This study is intended to retrospectively investigate the efficacy and safety of endoscopic treatment of esophageal-gastric fundus variceal bleeding. Methods A total of 95 inpatients with esophageal-gastric fundus variceal bleeding admitted to the Nanping First Hospital Affiliated to Fujian Medical University from July 2017 to January 2021 were selected as the study subjects. A retrospective method was used in this study, and these patients were divided into the control group(n=30) and the endoscopic treatment group(n=65) according to different treatment methods. The endoscopic treatment group was further divided into a ligation-only group(n=25) and a combined treatment group(n=40). The overall effective rate of hemostasis, mortality rate, hemostatic time, rebleeding rate and incidence of complications of the three groups were counted and analyzed. Results The total effective rate of hemostasis in simple ligation-only group and combined treatment group was significantly higher than that in control group(P < 0.05). The effective rate of hemostasis in the simple ligation-only group and the combined treatment group at different times was significantly higher than that in the control group(P < 0.05).The rebleeding rate within one year in the simple ligation-only group and the combined treatment group was significantly lower than that in the control group(P < 0.05). There was no significant difference between the combined treatment group and the simple ligation-only group in the rate of rebleeding within 2 weeks, 8 weeks and 1 year(P > 0.05). There was no significant difference in the total incidence of complications of endoscopic therapy(P > 0.05). Conclusion Compared with medically conservative treatment, endoscopic treatment of esophageal-gastric

关 键 词：内镜下治疗 食管静脉套扎术 联合治疗 食管胃底静脉曲张破裂出血 

分 类 号：R575.2[医药卫生—消化系统]