内镜下置入弹簧圈联合组织胶栓塞治疗食管胃底静脉曲张对患者康复速度和胃肠功能的影响  

Effect of endoscopic placement of spring coils combined with tissue glue embolization in the treatment of esophageal and gastric varicose veins on patient recovery speed and gastrointestinal function

作　　者：黄坚彬 陈志祥 林介军 HUANG Jianbin;CHEN Zhixiang;LIN Jiejun(Gastroenterology Department,Wenzhou Central Hospital,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市中心医院消化内科,浙江温州325000

出　　处：《手术电子杂志》2024年第6期46-50,57,共6页Electronic Journal of Medical Operations

摘　　要：目的 探讨内镜下实施弹簧圈置入联合组织胶栓塞治疗肝硬化伴食管胃底静脉曲张破裂出血的临床效果。方法 选取2019年1月—2024年1月在温州市中心医院实施治疗的肝硬化伴食管胃底静脉曲张破裂出血患者的病历资料进行回顾性分析,其中75例采用内镜下实施弹簧圈置入联合组织胶栓塞方案治疗的患者纳入联合组,另外选取74例仅采取内镜下组织胶栓塞方法治疗的患者纳入栓塞组,对比两组治疗的有效性、安全性,治疗前后的外周血血红蛋白(Hb)、红细胞(RBC)、白蛋白(ALB)、血小板(PLT)、胃底静脉曲张直径、胃泌素(GAS)、胃动素(MTL)及住院时间差异。结果 联合组患者的3个月再出血率、组织胶用量均低于栓塞组患者,差异均具有统计学意义(P<0.05);术后3个月,联合组患者外周血Hb、ALB测定值高于栓塞组,差异具有统计学意义(P<0.05),联合组患者血清GAS、MTL均低于栓塞组,差异均具有统计学意义(P<0.05);联合组的手术并发症5.33%与栓塞组患者的12.16%比较,差异均无统计学意义(P>0.05)。结论 内镜下实施弹簧圈置入联合组织胶栓塞方案治疗肝硬化伴食管胃底静脉曲张破裂出血,远期再出血率较低,更有利于患者的外周血指标和胃肠功能恢复。Objective To explore the clinical effect of endoscopic placement of spring coils combined with tissue glue embolization in the treatment of liver cirrhosis with esophageal and gastric variceal bleeding.Methods The medical records of patients with liver cirrhosis accompanied by esophageal and gastric variceal rupture and hemorrhage,who were treated in Wenzhou Central Hospital from January 2019 to January 2024,were retrospectively analyzed.75 patients who were treated with endoscopic spring coil implantation combined with tissue glue embolization were included in the combination group.In addition,74 patients who were only treated with endoscopic tissue glue embolization were included in the embolization group,and the efficacy and safety of the two groups were compared.Peripheral blood hemoglobin(Hb),red blood cells(RBC),albumin(ALB),platelets(PLT),gastric varices diameter,gastrin(GAS),motilin(MTL)and length of hospital stay were different before and after treatment.Results The 3-month rebleeding rate and tissue glue dosage in combination group were lower than those in embolization group,with statistical significance(P<0.05).3 months after surgery,the serum Hb and ALB values in the combination group were higher than those in the embolization group,with statistical significance(P<0.05),and serum GAS and MTL levels in the combination group were lower than those in the embolization group,with statistical significance(P<0.05).The operative complication rate of 5.33%in the combination group was not statistically different from that of 12.16%in the embolization group(P>0.05).Conclusion Endoscopic implementation of spring coil insertion combined with tissue gel embolization for the treatment of liver cirrhosis with esophageal and gastric variceal bleeding has a lower long-term rebleeding rate,which is more conducive to the recovery of peripheral blood indicators and gastrointestinal function in patients.

关 键 词：内镜 弹簧圈置入 组织胶栓塞 胃底静脉曲张 出血 

分 类 号：R575.2[医药卫生—消化系统]