EVS、EVS+EVL续贯EVS和EVL续贯EVS治疗食管静脉曲张的疗效比较被引量：10

Comparison among endoscopic variceal slerotheropy,endoscopic variceal slerotheropy with sequential endoscopic variceal ligation plus endoscopic variceal slerotheropy,and endoscopic variceal ligation plus endoscopic variceal slerotheropy for esophageal var

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摘要目的:比较内镜下食管静脉曲张硬化治疗(EVS)、EVS+EVS加套扎(EVL)续贯EVS和EVL续贯EVS治疗食管静脉曲张的疗效.方法:乙型病毒性肝炎肝硬化食管静脉曲张破裂出血患者130例,随机分为EVS治疗组50例,EVS+EVL续贯EVS组40例,EVL续贯EVS组40例,比较3组食管静脉曲张的消失率、并发症、硬化剂总用量,患者住院天数和远期复发出血率.结果:三组患者治疗后食管静脉曲张消失率无差异;EVS组硬化剂应用总量、治疗次数和住院天数都高于EVS+EVL续贯EVS组,EVL续贯EVS组(95.64±37.51 mL vs 55.90±38.93 mL,32.15±26.97 mL;3.64±1.32 vs 1.85±1.18,1.35±0.88;25.92±8.69 vs 20.6±5.00 d,17.55±4.62 d;P均<0.05),而后两组之间没有差异;EVL续贯EVS组食管静脉曲张复发率高于另外两组(45% vs 12%,20%,P<0.05),而后两组间没有差异.3组间再出血发生率及并发症的发生率没有差别.结论:EVL续贯EVS和EVS+EVL续贯EVS在食管静脉曲张的治疗上优于单纯EVS,尤其后者兼具EVL和EVS的优点. AIM： To compare the efficacies for esophageal varicosis treated by endoscopic variceal slerotheropy （EVS）, endoscopic variceal slerotheropy with sequential endoscopic variceal ligation plus endoscopic variceal slerotheropy （EVS ＋ EVL ＋ EVS）, and endoscopic variceal ligation plus endoscopic variceal slerotheropy （EVL ＋ EVS）. METHODS： One hundred and thirty type B viral hepatitis-caused liver cirrhosis patients complicated with esophageal bleeding were allocated into 3 groups： 50 cases in EVS group, 40 in EVS ＋ EVL ＋ EVS group, and 40 in EVL ＋ EVS group. RESULTS： The cure rate of varicosis was not significantly different among these three groups. The amount of sclerosant, time of therapy and in-hospital days were significantly higher in EVS group than the other two groups （95.64 ± 37.51 mL vs 55.90 ± 38.93 mL, 32.15 ± 26.97 mL; 3.64 ± 1.32 vs 1.85 ± 1.18, 1.35 ± 0.88; 25.92 ± 8.69 d vs 20.6 ± 5.00 d, 17.55 ± 4.62 d; all P 〈 0.05）, but there was no significant difference between EVS ＋ EVL ＋ EVS group and EVL ＋ EVS group. Varicosis recurrence was more frequently happened in EVL ＋ EVS group than that in the other groups （45% vs 12%, 20%, P 〈 0.05）, but there was no significant difference between the later two groups. No significant difference was observed in the rate of repeated bleeding and complications among these groups. CONCLUSION： The efficacy of EVS ＋ EVL ＋ EVS and EVL ＋ EVS, especially EVS ＋ EVL ＋ EVS, are superior to that of EVS.

作者蔺武刘心娟姜国俊魏南芦月霞郭晶程留芳

机构地区北京世纪坛医院消化内科中国人民解放军总医院消化内科

出处《世界华人消化杂志》 CAS 北大核心 2007年第9期1020-1023,共4页 World Chinese Journal of Digestology

关键词食管静脉曲张硬化剂治疗套扎治疗 Esopahgeal varices Slerotherapy Ligation

分类号 R512.62 [医药卫生—内科学] R575.2 [医药卫生—消化系统]

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参考文献13

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