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内镜下套扎、硬化剂及组织胶注射治疗食管静脉曲张破裂出血的近期疗效观察
Short-term efficacy of EVL, EIS, and TAI in treatment of esophageal variceal bleeding
文章发布日期:2014年07月14日  来源:  作者:周年兰,张明娟,王甦,等  点击次数:2813次  下载次数:626次

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【摘要】:目的 观察肝硬化食管静脉曲张破裂出血患者行内镜下套扎、硬化剂及组织胶注射治疗后食管静脉曲张程度、红色征及门静脉高压性胃病的变化。方法 回顾性分析本院2011年9月-2013年9月收治的75例食管静脉曲张破裂出血患者,行首次内镜下套扎、硬化剂或组织胶注射治疗。2~4周后复查胃镜,对比治疗前后曲张食管静脉的数目与直径、红色征及门静脉高压性胃病在内镜下的改变。组内治疗前后的比较采用配对t检验,率的比较采用卡方检验。结果 治疗后曲张食管静脉的数目及直径均小于治疗前[(3.08±0.96) vs (3.75±0.60),t=5.26,P<0.05;(1.05±0.46) cm vs (1.49±0.26) cm,t=9.84,P<0.05)],差异均有统计学意义。红色征的发生率较治疗前降低,差异有统计学意义(26.67% vs 57.33%, χ2=14.48,P<0.05)。治疗后门静脉高压性胃病虽有所好转,但差异无统计学意义(70.67% vs 72.00%, χ2=0.03,P>0.05)。结论 内镜下套扎、硬化剂及组织胶注射治疗食管静脉曲张破裂出血的方法安全、有效。
【Abstract】:Objective To observe the changes in degree of varices, red signs, and portal hypertensive gastropathy in liver cirrhosis patients with esophageal variceal bleeding (EVB) after endoscopic variceal ligation (EVL), endoscopic injection sclerotherapy (EIS), and tissue adhesive injection (TAI). Methods A retrospective analysis was performed on 75 patients with EVB, who were initially treated with EVL, EIS, or TAI in our hospital from September 2011 to September 2013. At 2-4 weeks after operation, gastroscopy was performed to evaluate the changes in the number and diameter of varices, red signs, and portal hypertensive gastropathy. Within-group comparison was made by paired t test, and comparison of rates was made by chi-square test. Results The number and diameter of varices decreased significantly after endoscopic therapy (3.08±0.96 vs 3.75±0.60, t=5.26, P<0.05; 1.05±0.46 cm vs 1.49±0.26 cm, t=9.84, P<0.05). The rate of red signs also decreased significantly after operation (26.67% vs 57.33%, χ2=14.48, P<0.05). However, the rate of portal hypertensive gastropathy decreased nonsignificantly after treatment (70.67% vs 72.00%, χ2=0.03, P>0.05). Conclusion EVL, EIS, and TAI are effective and safe in liver cirrhosis patients with EVB.
【关键字】:食管和胃静脉曲张;胃肠出血;胃镜检查;结扎术;硬化疗法;组织黏合剂
【Key words】:esophageal and gastric varices; gastrointestinal hemorrhage; gastroscopy; ligation; sclerotherapy; tissue adhesives
【引证本文】:

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