胃镜下组织胶注射治疗肝硬化胃静脉曲张破裂出血的疗效评价

发布时间：2018-07-10 03:07

本文选题：肝硬化 + 胃静脉曲张出血　；参考：《中国内镜杂志》2017年02期

【摘要】：目的探讨胃镜下组织胶注射治疗肝硬化胃静脉曲张破裂出血的临床疗效及安全性。方法研究对象为2014年6月-2016年5月住院经胃镜确诊的肝硬化胃静脉曲张破裂出血的患者92例。其中,男72例,女20例。92例肝硬化患者的肝功能Child-Pugh分级:A级28例,B级36例,C级28例。胃镜下胃曲张静脉分型:GEV 1型80例,GEV 2型12例。所有患者均采用胃镜下高渗糖组织胶"三明治"夹心法注射治疗。结果 (1)92例肝硬化胃静脉曲张破裂出血的患者胃镜下组织胶注射治疗成功率100.0%,其中急诊胃镜下组织胶注射治疗的患者40例,即时止血率100.0%。65例患者术后6个月复查胃镜:显效22例,占33.8%;有效38例,占58.5%;无效5例,占7.7%。全部患者随访1~24个月,无早期再出血患者,晚期再出血率2.2%,无患者死亡;(2)并发症:组织胶注射治疗术中拔针出血发生率2.2%,术后胸痛发生率4.3%,腹胀发生率6.5%,排胶溃疡发生率15.2%,无发热、感染、腹痛和异位栓塞等并发症发生。结论胃镜下组织胶注射治疗肝硬化胃静脉曲张破裂出血的疗效确切,止血效果好,不良反应轻,再出血发生率低。
[Abstract]:Objective to investigate the clinical efficacy and safety of gastroscopic injection of tissue glue in the treatment of hepatic cirrhosis and gastric variceal hemorrhage. Methods from June 2014 to May 2016, 92 patients with gastric variceal bleeding from cirrhosis diagnosed by gastroscopy were enrolled in the study. Among them, there were 72 males and 20 females. 28 cases of liver function were classified as Child-Pugh grade A (28 cases) and B grade (36 cases) and C grade (28 cases). Gastroscopic classification of gastric varices type 1: GEV 1 in 80 cases and GEV 2 in 12 cases. All patients were treated with sandwich method under gastroscopy. Results (1) the success rate of endoscopic tissue glue injection was 100.0% in 92 patients with gastroesophageal variceal bleeding, 40 of whom were treated with emergency gastroscopic tissue glue injection. The immediate hemostasis rate was 100.0.65 patients were examined by gastroscope 6 months after operation: 22 cases were markedly effective (33.8%), 38 cases were effective (58.5%), 5 cases were ineffective (7.7%). All the patients were followed up for 1 to 24 months. The rate of late rebleeding was 2.2 and there was no death. (2) complications: the incidence of bleeding during the treatment of tissue glue injection was 2.2, the incidence of postoperative chest pain was 4.3, the incidence of abdominal distension was 6.5 and the incidence of gumming ulcer was 15.2. there were no complications such as fever, infection, abdominal pain and ectopic embolism. Conclusion Gastroscopic injection of tissue glue in the treatment of hepatic cirrhosis gastric variceal bleeding is effective, the hemostatic effect is good, the adverse reaction is light, and the incidence of rebleeding is low.
【作者单位】：西南医科大学附属医院消化内科;
【分类号】：R575.2

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