组织胶联合聚桂醇治疗胃底静脉曲张出血的排胶规律研究

发布时间：2018-08-22 10:46

【摘要】：目的研究内镜下组织胶联合聚桂醇治疗胃静脉曲张出血的排胶规律,评价其疗效及安全性。方法搜集该院2010年8月-2014年2月因肝硬化伴胃底静脉曲张破裂出血行内镜治疗的患者资料。组织胶联合聚桂醇治疗组(GIS组)患者101例,组织胶治疗组(Histoacryl组)患者70例,均于术后1周、2周、1个月、2个月、3个月、6个月、9个月、12个月及12个月以上对患者进行内镜随访,观察比较两组患者排胶规律和胃底静脉曲张治疗疗效。结果 GIS组术后2和3个月排胶患者比例较高,分别为33.3%和35.7%。Histoacryl组术后1和2个月排胶患者比例较高,分别为45.5%和23.8%。两组患者排胶形态与血管解剖结构相近,排胶颜色各异。排胶多发生在术后1~3个月,多在1年内排胶结束,胶体完全排出时间无明显规律可循。两组患者最早排胶时间比较无明显差异,各随访期排胶率(排胶患者例数/随访患者例数)比较差异无显著性,GIS组在缓解及消除GV方面疗效优于Histoacryl组(P0.01)。两组患者术后主要并发症为排胶合并溃疡、排胶引发出血。两组患者排胶再出血时间比较,GIS组早于Histoacryl组。排胶再出血率比较、溃疡发生率比较差异无显著性,所有入组患者均未发生异位栓塞等严重并发症。结论内镜下组织胶联合聚桂醇治疗胃底静脉曲张的疗效优于单纯组织胶,联合治疗不增加术后排胶出血机会,但可使术后排胶再出血时间提前。
[Abstract]:Objective to evaluate the efficacy and safety of endoscopic tissue glue combined with polycinnamol in the treatment of gastric variceal hemorrhage. Methods from August 2010 to February 2014, the data of patients with cirrhosis and bleeding of gastric variceal varices were collected. There were 101 cases in GIS group and 70 cases in Histoacryl group. All patients were followed up by endoscopy 1 week, 1 month, 2 months, 3 months, 6 months, 9 months, 12 months and more than 12 months after operation. To observe and compare the gumming rule and the curative effect of gastric varicose vein between the two groups. Results in the GIS group, the proportion of the patients with degumming at 2 and 3 months after operation was higher (33.3%) than that in the 35.7%.Histoacryl group (45.5% and 23.8%, respectively) 1 and 2 months after operation. The morphology of the two groups was similar to that of the vascular anatomy, and the color of the discharge was different. Most of the degumming occurred in 1 ~ 3 months after operation and ended within one year. There was no obvious rule for the complete excrete time of colloid. There was no significant difference in the earliest degumming time between the two groups, and there was no significant difference between the two groups in the rate of gelatin removal (the number of cases / cases followed up) in each follow-up period. The curative effect of GIs group on relieving and eliminating GV was better than that of Histoacryl group (P0.01). The main complications of the two groups were bleeding caused by exfoliation and ulceration. The bleeding time of GIs group was earlier than that of Histoacryl group. There was no significant difference in the incidence of ulcer and no serious complications such as ectopic embolism occurred in all the patients. Conclusion the curative effect of endoscopic tissue glue combined with polycinnamol in the treatment of gastric varices is better than that of simple tissue glue. The combined treatment does not increase the chance of bleeding, but it can advance the time of postoperative bleeding.
【作者单位】：天津医科大学第三中心临床学院消化内科;天津市第三中心医院消化内科;
【分类号】：R575.2

【参考文献】