GOV2型胃底静脉曲张内镜治疗术后再出血的临床观察  

Clinical observation of re-bleeding after endoscopic treatment of GOV2 type gastric fundal varices

作　　者：焦晨阳 伏亦伟[1] 赵治彬[1] JIAO Chenyang;FU Yiwei;ZHAO Zhibin(Department of Gastroenterology,Taizhou People's Hospital,Taizhou,Jiangsu 225300,China)

机构地区：[1]泰州市人民医院消化科,江苏泰州225300

出　　处：《手术电子杂志》2024年第4期33-35,47,共4页Electronic Journal of Medical Operations

基　　金：泰州市人民医院院级课题(ZL202215)

摘　　要：目的 总结2型胃底静脉曲张(GOV2)内镜治疗术后再出血的临床特征。方法 回顾性分析2019年1月—2022年12月泰州市人民医院消化科收治的GOV2型胃底静脉曲张行内镜治疗术后再出血的28例患者的出血病因、治疗方法及预后情况。结果 28名患者中,乙型病毒性肝炎后肝硬化22人(78.6%),原发性胆汁性肝硬化3人(10.7%),自身免疫性肝炎肝硬化2人(7.1%),酒精性肝硬化1人(3.6%)。再出血距初次内镜手术中位时间41(34, 89)d。24例(85.7%)出血原因为排胶溃疡出血,4例(14.3%)为新发胃底静脉曲张破裂出血。3例(10.7%)药物保守治疗后好转,25例(89.3%)行内镜下注射治疗。5例(17.9%)患者内镜注射治疗后出血死亡。结论 GOV2型胃底静脉曲张内镜治疗术后再出血病死率高,排胶溃疡出血为最常见原因,需要及时内镜治疗。Objective To summarize the clinical characteristics of re-bleeding after endoscopic treatment of GOV2-type gastric varices.Methods A retrospective analysis was conducted on 28 patients who experienced re-bleeding after endoscopic treatment of GOV2-type gastric varices and were treated in the Department of Gastroenterology at Taizhou People's Hospital,Affiliated with Nanjing Medical University,from January 2019 to December 2022.The study examined the causes of bleeding,treatment methods and prognosis.Results Among the 28 patients,22(78.6%)had liver cirrhosis due to hepatitis B,3(10.7%)had primary biliary cirrhosis,2(7.1%)had autoimmune hepatitis with cirrhosis,and 1(3.6%)had alcoholic cirrhosis.The median time to re-bleeding after the initial endoscopic procedure was 41(34,89)days.The bleeding causes were gastric variceal bleeding in 24 patients(85.7%)and rupture of newly developed gastric varices in 4 patients(14.3%).Three patients(10.7%)showed improvement after conservative drug therapy,while 25 patients(89.3%)underwent endoscopic injection therapy,five of whom(17.9%)experienced fatal bleeding after endoscopic injection therapy.Conclusion Re-bleeding after endoscopic treatment of GOV2-type gastric varices is associated with a high mortality rate,with gastric variceal bleeding,especially from gastroesophageal varices,being the most common cause.Timely endoscopic treatment is essential.

关 键 词：胃底静脉曲张 组织胶 聚桂醇 内镜治疗 

分 类 号：R57[医药卫生—消化系统]