一种组织胶改良注射方法联合食管套扎治疗食管胃静脉曲张的临床疗效

发布时间：2019-07-06 19:17

【摘要】：目的研究内镜下组织胶改良注射方法联合套扎治疗食管胃静脉曲张的临床疗效与安全性。方法 120例食管胃静脉曲张患者随机分为内镜下组织胶改良三明治注射法治疗组(A组)60例(聚桂醇-组织胶-聚桂醇)与内镜下单纯组织胶注射治疗组(B组)60例(碘油-组织胶-碘油)。对于合并食管静脉曲张者同步行套扎治疗。比较两组患者内镜下止血成功率、再出血率、胃曲张静脉改善率、食管曲张静脉消失率及并发症发生率。结果两组患者内镜下止血成功率分别为98.32%与96.41%,差异无统计学意义(P0.05)。A组胃曲张静脉改善率高于B组患者(94.83%vs 82.50%,P0.05)。两组食管曲张静脉消失率分别为86.67%、76.67%,差异具有统计学意义(P0.05)。A组组织胶用量少于B组[(2.47±0.79)m L vs.(3.02±0.68)m L,P0.05]。两组术后再出血、发热、菌血症发生率比较,差异均无统计学意义(P0.05),但A组患者术后胸腹痛发生率高于B组(70.00%vs 53.33%,P0.05)。B组1例患者术后出现异位肺栓塞,经内科保守治疗好转。结论内镜下改良组织胶注射方法联合套扎治疗可以发挥组织胶与聚桂醇各自优势而改善食管胃静脉曲张治疗效果,有必要对其做进一步研究。
[Abstract]:Objective to study the clinical efficacy and safety of endoscopic tissue glue injection combined with bandaging in the treatment of esophageal and gastric varicose veins. Methods 120 patients with esophageal and gastric varicose veins were randomly divided into endoscopic tissue glue modified sandwich injection group (group A) and endoscopic tissue glue injection group (group B, n = 60). Patients with esophageal varicose veins were treated with simultaneous bandaging. The success rate of endoscopic hemostasis, the rate of rebleeding, the improvement rate of gastric varicose veins, the disappearance rate of esophageal varicose vein and the incidence of complications were compared between the two groups. Results the success rate of endoscopic hemostasis in the two groups was 98.32% and 96.41% respectively, and there was no significant difference (P 0.05). The improvement rate of gastric varicose veins in). A group was higher than that in B group (94.83%vs 82.50%, P 0.05). The disappearance rate of esophageal varicose veins in the two groups was 86.67% and 76.67% respectively, the difference was statistically significant (P 0.05) the amount of tissue glue in). A group was less than that in group B [(2.47 卤0.79) m L vs. (3.02 卤0.68) mL, P 0.05]. There was no significant difference in the incidence of postoperative rebleeding, fever and bacteremia between the two groups (P 0.05), but the incidence of postoperative chest and abdominal pain in group A was higher than that in group B (70.00%vs 53.33%). One patient in). B group had ectopic pulmonary embolism after operation, which was improved by conservative medical treatment. Conclusion Endoscopic modified tissue glue injection combined with bandaging can improve the therapeutic effect of esophageal and gastric varicose by giving full play to the advantages of tissue glue and polycinnamol, so it is necessary to do further research on the treatment of esophageal and gastric varicose veins.
【作者单位】：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(编号:2015WS0365)
【分类号】：R575.2

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