改良三明治法同步与序贯联合套扎治疗食管胃底静脉曲张的疗效比较

发布时间：2018-03-27 21:48

本文选题：食管胃底静脉曲张　切入点：改良三明治法　出处：《中国内镜杂志》2017年02期

【摘要】：目的探讨改良三明治法同步与序贯联合套扎治疗食管胃底静脉曲张(EGV)的疗效。方法 42例EGV患者随机分为同步治疗组(22例)和序贯治疗组(20例),同步治疗组采用内镜下改良三明治法治疗胃底曲张静脉后,同时行食管曲张静脉套扎术(EVL),序贯治疗组采用内镜下改良三明治法治疗胃底曲张静脉后,隔一周分次行EVL。比较两组患者内镜下止血成功率、再出血率、胃底静脉曲张(GV)改善率、套扎器应用数目及腹痛、发热、菌血症和异位栓塞等不良反应发生率。结果两组患者内镜下止血成功率、再出血率、GV改善率差异无统计学意义,两组患者胸腹痛、发热、菌血症发生率差异无统计学意义。所有患者均未出现异位栓塞。两组患者分别平均应用(8.19±2.01)与(7.81±1.78)枚套扎环,食管静脉曲张(EV)消失率分别为59.09%与70.00%,差异均无统计学意义(P0.05)。结论内镜下一次性注射组织胶+聚桂醇同步联合套扎治疗EGV安全有效,并发症发生率低,且可减少内镜检查次数,减少患者痛苦及医疗费用,值得进一步研究。
[Abstract]:Objective to investigate the efficacy of modified sandwich method combined with sequential ligation in the treatment of esophageal and gastric varices (EGV). Methods 42 cases of EGV patients were randomly divided into synchronous treatment group (n = 22) and sequential therapy group (n = 20). Endoscopic modified sandwich method for treatment of varicose gastric fundus, At the same time, the esophageal variceal ligation was performed. The patients in the sequential treatment group were treated with endoscopic modified sandwich method for the treatment of gastric varices. The success rate of endoscopic hemostasis, the rate of rebleeding and the improvement rate of GV were compared between the two groups. Results there was no significant difference between the two groups in the success rate of endoscope hemostasis and the improvement rate of GV. There was no significant difference between the two groups in chest and abdominal pain, fever, fever, and other adverse reactions, such as abdominal pain, fever, bacteremia and ectopic embolism. There was no significant difference in the incidence of bacteremia. No ectopic embolism was found in all the patients. The two groups were treated with an average of 8.19 卤2.01 and 7.81 卤1.78 ligation rings, respectively. The disappearance rate of esophageal variceal varices was 59.09% and 70.00.The difference was not statistically significant (P 0.05). Conclusion it is safe and effective to treat EGV with simultaneous injection of tissue colloid and cinnamol under endoscope, the incidence of complications is low, and the frequency of endoscopic examination can be reduced. Reducing patient pain and medical costs is worth further study.
【作者单位】：山东省临沂市中心医院消化科;
【基金】：山东省医药卫生科技发展计划项目(No:2015WS0365)
【分类号】：R575.2

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