内镜下胃底静脉曲张治疗方法选择及再出血情况分析

Therapeutic selection of endoscopic varices of gastric fundus and analysis for re-bleeding

  • 摘要:
      目的  探讨内镜下胃底静脉曲张治疗方法选择及再出血情况。
      方法  选取68例胃底静脉曲张患者作为研究对象,平均分为2组。A组予以组织胶黏合剂注射结合硬化剂治疗, B组予以内镜下套扎术联合组织胶黏合剂治疗。观察并比较2组的临床疗效、止血情况、静脉曲张根除情况、住院情况、再出血情况、1年生存率、并发症情况。
      结果  B组的临床治疗总有效率、治疗1 d后止血率、静脉曲张根除率均略高于A组,但差异无统计学意义(P>0.05); B组治疗后7 d的止血率显著高于A组(P < 0.05); B组的住院时间显著短于A组(P < 0.05); B组近期再出血率略低于A组,但差异无统计学意义(P>0.05); B组远期再出血率显著低于A组(P < 0.05); B组1年生存率略高于A组,但差异无统计学意义(P>0.05); B组并发症发生率显著低于A组(P < 0.05)。
      结论  对胃底静脉曲张破裂出血患者采用内镜下套扎手术联合组织黏合剂注射治疗效果良好,其止血率、远期再出血率以及并发症发生率均显著优于组织胶黏合剂注射联合硬化剂治疗。

     

    Abstract:
      Objective  To investigate the selection of endoscopic treatment for varices of gastric fundus and analysis for rebleeding.
      Methods  A total of 68 patients with gastric varices were divided into two groups. Group A was treated with tissue adhesive injection combined with sclerotherapy. Group B were treated with endoscopic ligation combined with tissue adhesive injection. The clinical efficacy, hemostatic condition, conditions of varicose eradication, hospital stay, rehaemorrhagia, 1-year survival rate and complications were observed and compared between the two groups.
      Results  The total effective rate, hemostasis rate at 1 d after treatment and varicose eradication rate of group B were slightly higher than those of group A, but the differences showed no statistically significant (P>0.05); The hemostasis rate at 7 d after treatment in group B was significantly higher, and the length of hospital stay was significantly shorter than that in group A(P < 0.05). The recent rehaemorrhagia rate of group B was slightly lower than that of group A, but the difference was not statistically significant(P>0.05). The long-term rehaemorrhagia rate of group B was significantly lower(P < 0.05). The 1-year survival rate of group B was slightly higher than that of group A, but the difference was not statistically significant(P>0.05); The incidence of complications in group B was significantly lower than that in group A (P < 0.05).
      Conclusion  Endoscopic ligation combined with tissue adhesive injection for patients with gastric variceal bleeding has good therapeutic effects, and better outcomes in hemostasis rate, long-term rehaemorrhagia rate and complication rate than tissue adhesive injection combined with sclerotherapy.

     

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