摘要
目的探讨胃镜下精准断流术在肝硬化食管胃静脉曲张出血患者中的临床应用价值。方法纳入福建医科大学附属漳州市医院2017年1月至2018年12月肝硬化食管胃静脉曲张出血患者116例,72例行胃镜下精准断流术(精准断流组),44例行传统断流术(传统断流组),对比两组治疗的显效率、有效率及再出血率、内镜治疗次数和并发症情况。结果术后1个月,精准断流组显效率15.3%,有效率59.7%,传统断流组显效率9.1%,有效率47.7%,差异有统计学意义(Z=-2.023,P=0.043);术后3个月精准断流组再出血率12.5%,低于传统断流组再出血率27.3%,差异有统计学意义(χ~2=4.020,P=0.045)。精准断流组内镜治疗次数(1.44±0.65)次,少于传统断流组(1.68±0.74)次,差异无统计学意义(t=1.756,P=0.083)。并发症主要为胸痛、上腹痛(精准断流组23.6%,传统断流组18.2%)及发热(精准断流组9.7%,传统断流组15.9%),差异无统计学意义(P>0.05)。结论胃镜下精准断流术疗效更高,安全性好。
Objective To explore clinical value of endoscopic selective varices devascularization for esophagogastric variceal bleeding. Methods A total of 116 cases of liver cirrhosis patients with esophagogastric variceal bleeding were selected from Jan. 2017 to Dec. 2018 in Zhangzhou Affiliated Hospital of Fujian Medical University, 72 patients received endoscopic selective varices devascularization(selective treatment group), 44 patients received traditional varices devascularization(traditional treatment group). The excellence rate, effective rate, rebleeding rate and complications were compared between the two groups. Results One month after treatment, excellence rates in the selective treatment group and traditional treatment group were 15.3% and 9.1%, the effective rates of two groups were 59.7% and 47.7%, the difference was statistically significant(Z=-2.023,P=0.043). Three months after treatment, the rebleeding rate was 12.5% in the selective treatment group, which was significantly lower than that in the traditional treatment group(27.3%)(χ~2=4.020, P=0.045). The average times of treatments were 1.44±0.65 in the selective treatment group, 1.68±0.74 in the traditional treatment group, there was no significant difference between the two groups(t=1.756, P=0.083). The complications including poststernal pain, epigastric pain(23.6% in the selective treatment group vs 18.2% in the traditional treatment group) and fever(9.7% in the selective treatment group vs 15.9% in the traditional treatment group), the difference was not statistically significant(P>0.05). ConclusionEndoscopic selective varices devascularization is safe and shows good efficacy.
作者
陈和清
许秋泳
赖亚栋
许耀斌
林淑惠
CHEN Heqing;XU Qiuyong;LAI Yadong;XU Yaobin;LIN Shuhui(Department of Gastroenterology,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China)
出处
《胃肠病学和肝病学杂志》
CAS
2020年第5期552-555,共4页
Chinese Journal of Gastroenterology and Hepatology
基金
福建省卫生计生青年科研课题(2017-1-90)。
关键词
肝硬化
食管胃静脉曲张
胃镜下精准断流术
Liver cirrhosis
Esophagogastric varices
Endoscopic selective varices devascularization
