内镜下组织胶注射联合硬化-套扎术治疗肝硬化食管胃底静脉曲张患者临床研究

doi:10.3969/j.issn.1672-5069.2020.06.023

摘要/Abstract

摘要： 目的探讨内镜下组织胶注射联合硬化-套扎术治疗肝硬化并发食管胃底静脉曲张(EGV)患者的临床疗效。方法 2017年7月～2019年2月我院收治的肝硬化并发EGV患者76例,采用随机数字表法分为对照组38例和观察组38例。在对照组采用内镜下套扎术治疗,在观察组采用内镜下组织胶注射联合硬化-套扎术治疗,术后均随访6个月。结果在术后第6个月随访时,对照组失访2例(5.3%),死亡5例(13.2%),观察组失访3例(7.9%),死亡2例(5.3%),两组总有效率分别为71.0%对81.8%,差异显著(P<0.05);术后,观察组再出血、吞咽不适和食管狭窄发生率分别为24.2%、18.2%和15.2%,显著低于对照组的41.9%、35.5%和25.8%(P<0.05)。结论采用内镜下组织胶注射联合硬化-套扎术治疗肝硬化并发食管胃底静脉曲张患者临床疗效满意,不良反应发生率低,值得临床应用和研究。

关键词: 肝硬化, 食管胃静脉曲张, 套扎, 硬化剂, 组织胶, 内镜下治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of endoscopic tissue gel injection and sclerotherapy-ligation in the treatment of patients with esophageal and gastric varices (EGV). Methods 76 cirrhotic patients with EGV were recruited in our hospital from July 2017 through February 2019, and were randomly divided into control group (n=38) and combination group (n=38). The patients in the control group were treated with endoscopic ligation and those in the combination group were treated with endoscopic tissue glue injection and sclerotherapy-ligation combination. All patients were followed-up for 6 months. Results At the end of 6-month follow-up, 2 cases (5.3%) lost and 5 cases (13.2%) died in the control group, 3 cases (7.9%) lost and 2 cases (5.3%) died in the combination, and the total efficient rates were 71.0% in the control to 81.8% in the combination (P<0.05); the incidence of postoperative rebleeding, obstruction and esophageal stricture in the combination group was 24.2%, 18.2% and 15.2%, significantly lower than 41.9%, 35.5% and 25.8% (P<0.05) in the control. Conclusion Endoscopic tissue gel injection combined with sclerotherapy-ligation is efficacious in the treatment of cirrhotic patients with esophagogastric varices to prevent rebleeding with low incidence of adverse reactions, which worth further clinical investigation.

Key words: Liver cirrhosis, Esophageal and gastric varices, Endoscopic variceal ligation, Endoscopic sclerotherapy, Tissue gel injection, Therapy

冯凯, 郭爱华, 黄鹿, 张清, 郭拥军, 向灿. 内镜下组织胶注射联合硬化-套扎术治疗肝硬化食管胃底静脉曲张患者临床研究[J]. 实用肝脏病杂志, 2020, 23(6): 849-852.

Feng Kai, Guo Aihua, Huang Lu, et al. Clinical study of endoscopic tissue gel injection and sclerotherapy-ligation in the treatment of cirrhotic patients with esophageal and gastric varices[J]. Journal of Practical Hepatology, 2020, 23(6): 849-852.

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