摘要
目的探讨急诊内镜治疗肝硬化食管胃底静脉曲张出血(EGVB)的最佳治疗方案。方法EGVB患者960例,随机分为3个治疗组,即单纯套扎(EVL)组328例,单纯硬化(EVS)组322例,套扎+硬化(EVL+EVS)组310例;以止血成功率(ARH)及再出血率(RR)评价疗效。结果EVL+EVS组的ARH(98.7%,306/310)显著高于EVL组(94.8%,311/328)及EVS组(94.1%,303/322)(χ2=9.70,P<0.01);EVL+EVS组的RR(9.7%,30/310)与EVL组(15.9%,52/328)及EVS组(15.5%,50/322)比较差异无统计学意义(χ2=6.42,P>0.05)。结论EVL+EVS治疗肝硬化EGVB能显著提高急诊止血成功率,减少了内镜治疗次数及硬化剂用量,为目前急诊内镜治疗EGVB较为安全有效的方法。
Objective To investigate the best emergent endoscopic therapy for esophageal and gastric varieeal bleeding（EGVB）. Methods Nine hundred and sixty patients with esophageal and gastric varieeal bleeding were randomly assigned to three groups： endoscopic varieeal ligation （EVL）group （n = 328）, endoscopic varieeal selerotherapy（EVS） group（ n 322） and EVL＋EVS group（ n =310）. The therapeutic effects of three groups were evaluated by achievement ratio of hemostasis（ARH） and ratio of rehaemorrhagia（RR）. Results ARH of EVL＋EVS group（98.7% ,306/310）was remarkably higher than that of EVL group（94.8% ,311/328） and EVS group（94.1%, 303/322） （x^2=-9.70, P 〈0.01）. RR of EVL＋EVS group（9.7%, 30/310） showed no slgnifieant difference with that of EVL group（15.9%,52/328）and EVS group（15.5% ,50/322） （x^2=6.42, P〉0.05）. Coneluslon Emergent EVL＋ EVS for esophageal and gastric varieeal bleeding can remarkably improve ARH. This eombinant therapy cuts down the frequency of endoscopic therapy and selerosant dosage. It is a safe and effective therapy for esophageal and gastric varieeal bleeding at present.
出处
《临床荟萃》
CAS
北大核心
2006年第12期845-846,共2页
Clinical Focus
关键词
食管和胃静脉曲张
胃肠出血
肝硬化
内窥镜检查
胃肠道
急诊处理
esophageal and gastric variees
gastrointestinal hemrrhagel liver cirrhosis
endoscopy, gastrointestinal
emergency treatment
