胃镜下聚桂醇注射治疗肝硬化并发食管静脉曲张患者临床疗效研究

doi:10.3969/j.issn.1672-5069.2019.03.020

摘要/Abstract

摘要： 目的探讨在胃内镜下聚桂醇注射治疗肝硬化并发食管静脉曲张患者的临床疗效及安全性。方法 2016年1月~2017年12月在我院行内镜下硬化治疗的肝硬化并发食管静脉曲张患者80例,其中38例接受内镜下注射聚桂醇治疗,另42例接受内镜下注射鱼肝油酸钠治疗,随访12个月。结果注射聚桂醇组显效和有效率分别为65.8%和26.3%,与注射鱼肝油酸钠组的69.0%和26.2%比,差异无统计学意义（P>0.05）;注射聚桂醇组急诊止血成功率和再出血发生率分别为92.1%和34.2%,与注射鱼肝油酸钠组的95.2%和31.0%比,差异均无统计学意义（P>0.05）;注射聚桂醇组术后发热、胸痛、溃疡和食管狭窄发生率分别为13.2%、13.2%、10.5%和2.6%,均明显低于注射鱼肝油酸钠组（分别为33.3%、38.1%、42.9%和19.1%,P<0.05）;在随访3个月、6个月和12个月时,注射聚桂醇组曲张静脉复发率分别为10.53%、18.42%和28.95%,与注射鱼肝油酸钠组的9.52%、14.29%和30.95%比差异无统计学意义（P>0.05）。结论在胃内镜下注射聚桂醇治疗肝硬化并发食管静脉曲张患者止血成功率高,疗效确切,且术后并发症发生率较低,是一种安全有效的治疗方法。

关键词: 肝硬化, 食管静脉曲张, 硬化治疗术, 聚桂醇, 内镜, 止血, 复发

Abstract: Objectiv The aim of this study was to evaluate the clinical efficacy of gastroscopic lauromacrogol injection in treatment of patients with liver cirrhosis and esophageal varices. Methods A retrospective analysis was performed in 80 patients with liver cirrhosis and esophageal varices who underwent endoscopic injection sclerotherapy （EIS） in our hospital between January 2016 and December 2017. Among them,38 patients underwent endoscopic injection with lauromacrogol and 42 cases underwent endoscopic injection of sodium morrhuate. All patients were followed-up for 12 months. The statistical analysis was performed on the disappearance of varices,hemostasis,postoperative complications and recurrence of varices during the followed-up periods. Results In lauromacrogol-injected group,the disappearance of varices and narrowed varices were 65.8% and 26.3%,not significantly different as compared to 69.0% and 26.2%,respectively,in sodium morrhuate-injected group（P>0.05）;the successful rate of emergent hemostasis and incidence of rebleeding in lauromacrogol-injected group were 92.1% and 34.2%, respectively,not significantly different as compared to 95.2% and 31.0%,respectively,in sodium morrhuate-injected group（P>0.05）;the incidence rates of postoperative complications such as fever,chest pain,ulcer and esophageal stricture in the lauromacrogol-injected group were 13.2%,13.2%,10.5% and 2.6%,respectively,which were significantly lower than 33.3%,38.1%,42.9% and 19.1% in sodium morrhuate-injected group（P<0.05）;at 3 months,6 months and 12 months of followed-up,the recurrence rates of varices in lauromacrogol-injected group were 10.53%,18.42% and 28.95%,respectively,not significantly different as compared to 9.52%,14.29% and 30.95%,respectively,in sodium morrhuate-injected group （P>0.05）. Conclusion The successful rate of hemostasis is as high as with morrhuate injection in patients with liver cirrhosis and esophageal varices undergoing gastroscopic injection of lauromacrogol, which might improve clinical efficacy with less postoperative complications. It is a safe and effective treatment regimen.

Key words: Liver cirrhosis, Esophageal varices, Sclerotherapy, Lauromacrogol, Endoscopy, Hemostasis, Recurrence

凌晶, 王娟. 胃镜下聚桂醇注射治疗肝硬化并发食管静脉曲张患者临床疗效研究[J]. 实用肝脏病杂志, 2019, 22(3): 389-392.

Ling Jing, Wang Juan. Clinical efficacy of gastroscopic lauromacrogol injection in treatment of patients with liver cirrhosis and esophageal varices[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(3): 389-392.

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