胃镜下食管套扎联合胃底组织胶栓堵术治疗食管胃底静脉曲张破裂出血患者的临床效果  

Clinical effect of esophageal ligation combined with gastric fundus tissue glue plug occlusion under gastroscopy in the treatment of patients with esophageal and gastric varices bleeding

作　　者：王雯菁 姚红娟 乔京贵[1] 孙利慧 宋瑛 WANG Wenjing;YAO Hongjuan;QIAO Jinggui;SUN Lihui;SONG Ying(Xi'an Gaoxin Hospital,Xi'an 710075,China)

机构地区：[1]西安高新医院,陕西西安710075

出　　处：《临床医学研究与实践》2024年第20期26-29,46,共5页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2021SF-316)。

摘　　要：目的探讨胃镜下食管套扎联合胃底组织胶栓堵术治疗食管胃底静脉曲张破裂出血的有效性和安全性。方法回顾性选取2018年2月至2020年4月就诊于我院的100例肝硬化食管胃底静脉曲张破裂出血患者作为研究对象,根据治疗方案不同将其分为A组(n=50)和B组(n=50)。A组采用胃镜下食管硬化联合胃底组织胶栓堵术治疗,B组采用胃镜下食管套扎联合胃底组织胶栓堵术。比较两组的再出血情况、治疗效果、实验室指标、并发症发生情况及住院天数。结果B组的再出血率显著低于A组,差异具有统计学意义(P<0.05)。B组的治疗总有效率显著高于A组,差异具有统计学意义(P<0.05)。治疗前、后,两组的血红蛋白(HGB)水平、白细胞计数(WBC)、血小板计数(PLT)、凝血酶原时间(PT)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)以及总胆红素(TBIL)水平比较,差异无统计学意义(P>0.05)。B组的并发症总发生率为34.00%,显著高于A组的8.00%,差异具有统计学意义(P<0.05)。两组的住院天数比较,差异无统计学意义(P>0.05)。结论相比于胃镜下食管硬化联合胃底组织胶栓堵术,胃镜下食管套扎联合胃底组织胶栓堵术治疗食管胃底静脉曲张破裂出血的效果更好,可降低再出血率,提高治疗总有效率,但并发症发生率较高,临床可根据患者的具体情况进行手术方案选择。Objective To investigate the efficacy and safety of esophageal ligation combined with gastric fundus tissue glue plug occlusion under gastroscopy in the treatment of esophageal and gastric varices bleeding.Methods A total of 100 patients with esophageal and gastric varices bleeding caused by liver cirrhosis who were admitted in our hospital from February 2018 to April 2020 were retrospectively selected.According to different treatment regimens,the patients were divided into group A(n=50)and group B(n=50).The group A was treated with esophageal sclerosis combined with gastric fundus tissue glue plug occlusion under gastroscopy,and the group B was treated with esophageal ligation combined with gastric fundus tissue glue plug occlusion under gastroscopy.The rebleeding,treatment effect,laboratory indexes,complications and hospitalization days were compared between the two groups.Results The rebleeding rate of the group B was significantly lower than that of the group A,and the difference was statistically significant(P<0.05).The total effective rate of treatment in the group B was significantly higher than that in the group A,and the difference was statistically significant(P<0.05).Before and after treatment,there were no significant differences in the hemoglobin(HGB)level,white blood cell cout(WBC),platelet count(PLT),prothrombin time(PT),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)levels between the two groups(P>0.05).The total incidence of complications in the group B was 34.00%,which was significantly higher than 8.00%in the group A,and the difference was statistically significant(P<0.05).There was no significant difference in hospitalization days between the two groups(P>0.05).Conclusion Compared with esophageal sclerosis combined with gastric fundus tissue glue plug occlusion under gastroscopy,esophageal ligation combined with gastric fundus tissue glue plug occlusion under gastroscopy has better effect in the treatment of esophageal and gastric varices bleeding,which c

关 键 词：肝硬化 食管胃底静脉曲张破裂出血 食管静脉曲张套扎术 胃底组织胶栓堵术 食管静脉曲张硬化术 胃镜 

分 类 号：R575.2[医药卫生—消化系统]