摘要
目的探讨肝硬化合并胃底静脉曲张患者采用内镜下连续密集套扎术治疗的效果及并发症发生情况。方法肝硬化合并胃底静脉曲张患者109例,其中采用内镜下连续密集套扎术治疗者60例为观察组,采用内镜下硬化剂联合组织胶注射治疗者49例为对照组。比较2组Child-Pugh分级、肝硬化病因及术后胸骨后不适、腹痛、恶心呕吐、发热等不良反应总发生率。随访1年,比较2组治疗总有效率,随访期间早期再出血、迟发性再出血、死亡发生情况,组织胶注射引起的异位栓塞、套扎环脱落、食管严重狭窄发生情况。结果2组Child-Pugh分级、肝硬化病因比较差异均无统计学意义(P>0.05)。观察组术后不良反应总发生率(68.33%)与对照组(53.06%)比较差异无统计学意义(χ^(2)=1.454,P=0.228)。观察组治疗总有效率(96.67%)高于对照组(77.55%)(χ^(2)=9.383,P=0.002);2组随访期间均未发生组织胶注射引起的异位栓塞、套扎环脱落、食管严重狭窄;观察组随访期间早期再出血发生率(8.33%)、迟发性再出血发生率(11.67%)、病死率(5.00%)与对照组(6.12%、24.49%、6.12%)比较差异均无统计学意义(P>0.05)。结论内镜下连续密集套扎术治疗肝硬化胃底静脉曲张疗效较内镜下硬化剂联合组织胶注射治疗好,不增加术后不良反应及并发症的发生。
Objective To investigate the efficacy and complications of endoscopic continuous intensive ligation therapy for gastric varices in patients with hepatic cirrhosis.Methods In 109 patients with hepatic cirrhosis and gastric varices,60 patients received endoscopic continuous intensive ligation(observation group)and 49 patients received endoscopic injection of curing agent and tissue glue(control group).The Child-Pugh classification,etiology of cirrhosis,and incidences of postoperative retrosternal discomfort,abdominal pain,nausea/vomiting and fever were observed and compared between two groups.All patients were followed up for 1 year.The total effective rate,incidences of early rebleeding,delayed rebleeding and death,and incidences of ectopic embolism,dislodgement of the ligature ring and severe esophageal stricture due to tissue glue injection were compared between two groups.Results There were no significant differences in the Child-Pugh classification and etiology of cirrhosis between two groups(P>0.05).There was no significant difference in the total incidence of postoperative adverse reactions between observation group(68.33%)and control group(53.06%)(χ^(2)=1.454,P=0.228).The total effective rate was higher in observation group(96.67%)than that in control group(77.55%)(χ^(2)=9.383,P=0.002).No ectopic embolism,dislodgement of the ligature ring or severe esophageal stricture due to tissue glue injection occurred during the follow-up period in two groups.There were no significant differences in the incidence of early rebleeding,delayed rebleeding and fatality during the follow-up period between observation group(8.33%,11.67%,5.00%)and control group(6.12%,24.49%,6.12%)(P>0.05).Conclusion Compared with endoscopic injection of curing agent and tissue glue,endoscopic continuous intensive ligation is effective for gastric varices in patients with hepatic cirrhosis,without increasing the incidence of postoperative adverse reactions and complications.
作者
张名超
王帝
江小柯
丁辉
李修岭
ZHANG Ming-chao;WANG Di;JIANG Xiao-ke;DING Hui;LI Xiu-ling(Xinxiang Medical University,Henan 453000,China;Department of Gastroenterology,Henan Provincial People’s Hospital,Zhengzhou University People’s Hospital,Zhengzhou,Henan 450003,China)
出处
《中华实用诊断与治疗杂志》
2022年第6期631-633,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划项目(SB201903015)。
关键词
肝硬化
胃底静脉曲张
内镜
套扎术
硬化剂
组织胶
hepatic cirrhosis
gastric varices
endoscopy
ligature
curing agent
tissue glue
