摘要
目的 探讨胃镜联合小探头超声在胃底静脉曲张诊断及治疗中的应用价值。方法 选取河北省承德市中心医院2016年6月至2020年6月因肝硬化伴胃底静脉曲张破裂出血的138例住院患者,按照随机数字表法分为对照组(70例)和观察组(68例)。对照组应用单纯胃镜常规检查并做内镜下组织胶注射治疗,观察组应用胃镜联合小探头超声检查并做内镜下组织胶注射治疗,在治疗后1周、1个月、3个月、6个月分别使用单纯胃镜和胃镜联合小探头超声复查,仍存在胃底静脉曲张者再次做内镜下组织胶注射治疗。观察两组的胃底静脉曲张检出率、人均治疗次数、人均用胶量、治疗后1年及末次治疗后1年胃底静脉曲张再次破裂出血发生率。结果 治疗后1周、3个月、6个月复查,观察组胃底静脉曲张检出率均优于对照组(P<0.05);治疗后1个月复查,两组胃底静脉曲张检出率差异无显著性(P>0.05)。治疗后1年对照组再次破裂出血发生率为11.43%,高于观察组的1.47%,末次治疗后1年对照组再次破裂出血发生率为32.86%,高于观察组的16.18%,差异均有显著性(P<0.05)。对照组患者共治疗67次,平均(0.96±1.01)次,观察组患者共治疗102次,平均(1.50±0.97)次,两组差异有显著性(P<0.001)。对照组患者总用胶量244.5ml,人均用胶量(3.49±1.55)ml,观察组患者总用胶量238.5ml,人均用胶量(3.51±0.53)ml,两组差异无显著性(P>0.05)。结论 相较于单纯胃镜,胃镜联合小探头超声检查的胃底静脉曲张检出率高,治疗后胃底静脉曲张再次破裂出血发生率低,组织胶注射治疗次数多但用胶量并未增加。
Objective To investigate the application value of gastroscopy combined with miniprobe sonography in the diagnosis and treatment of varicose gastric fundus.Method A total of 138 hospitalized patients with cirrhosis accompanied by gastric variceal rupture and hemorrhage from June 2016 to June 2020 in Chengde Central Hospital were selected and divided into control group(70 cases)and experimental group(68 cases)according to random number table method.The control group was treated with simple routine gastroscopy and endoscopic tissue glue injection;the experimental group was treated with gastroscopy combined with miniprobe sonography and endoscopic tissue glue injection.The patients who still had gastric fundus varicose veins were treated with endoscopic tissue glue injection again at 1 week,1 month,3 months and 6 months after treatment,respectively.The detection rate of gastric varicose veins,the number of treatments per capita and the amount of glue per capita were observed in the two groups.The recurrence rate of gastric variceal hemorrhage within 1 year after treatment and 1 year after treatment were observed.Result After 1 week,3 months and 6 months,the detection rate of gastric varicose veins in the experimental group was better than that in the control group(P<0.05).One month after treatment,there was no significant difference between the two groups(P>0.05).The recurrence rate of ruptured bleeding in the experimental group was lower than that in the control group,and the difference was significant(P<0.05).The rate of rebleeding in the experimental group was lower than that in the control group,the difference was significant(P<0.05).The control group was treated 67 times,with an average of(0.96±1.01)times,while the experimental group was treated 102 times,with an average of(1.50±0.97)times,with significant difference between the two groups(P<0.001).The total amount of glue used in control group was 244.5ml,(3.49±1.55)ml per capita,while the total amount of glue used in experimental group was 238.5ml,(3.51±0.53)ml per capita,with no significant difference(P>0.05).Conclusion Compared with gastroscopy alone,gastroscopy combined with miniprobe sonography has a higher detection rate of gastric varices,a lower recurrence rate of gastric varices rupture and bleeding after treatment,and more times of tissue glue injection but no increase in the amount of glue used.
作者
齐静
郝欣
刘小双
刘伟
孙志欣
Qi Jing;Hao Xin;Liu Xiaoshuang;Liu Wei;Sun Zhixin(Department of Gastroenterology,Chengde Central Hospital,Hebei Chengde 067000,China;Department of Thoracic and Rectal Surgery,Chengde Central Hospital,Hebei Chengde 067000,China)
出处
《中国医刊》
CAS
2023年第10期1075-1078,共4页
Chinese Journal of Medicine
基金
2020年承德市科学技术研究与发展计划项目(202002A012)。
关键词
肝硬化
胃镜
小探头超声
胃底静脉曲张
组织胶
Liver cirrhosis
Gastroscope
Miniprobe sonography
Gastric varices
Tissue glue
