[1]陈敬成.内镜下硬化剂联合组织胶注射治疗门静脉高压合并食管胃静脉曲张的疗效及排胶再出血率观察[J].医学信息,2022,35(08):159-161.[doi:10.3969/j.issn.1006-1959.2022.08.041]
　CHEN Jing-cheng.Efficacy of Endoscopic Sclerotherapy Combined with Tissue Glue Injection in the Treatment of Portal Hypertension Complicated with Esophageal and Gastric Varices and Observation of Rebleeding Rate[J].Medical Information,2022,35(08):159-161.[doi:10.3969/j.issn.1006-1959.2022.08.041]
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内镜下硬化剂联合组织胶注射治疗门静脉高压合并食管胃静脉曲张的疗效及排胶再出血率观察()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年08期
页码:
159-161
栏目:
药物与临床
出版日期:
2022-04-15

文章信息/Info

Title:
Efficacy of Endoscopic Sclerotherapy Combined with Tissue Glue Injection in the Treatment of Portal Hypertension Complicated with Esophageal and Gastric Varices and Observation of Rebleeding Rate
文章编号:
1006-1959（2022）08-0159-03
作者:
陈敬成
（井冈山大学附属医院消化内科，江西 吉安 343000）
Author(s):
CHEN Jing-cheng
(Department of Gastroenterology,Affiliated Hospital of Jinggangshan University,Ji’an 343000,Jiangxi,China)
关键词:
门静脉高压; 食管胃静脉曲张; 内镜; 硬化剂; 组织胶; 血管闭塞
Keywords:
Portal hypertension; Gastroesophageal varices; Endoscopy; Hardening agent; Tissue glue; Vascular occlusion
分类号:
R571+.3
DOI:
10.3969/j.issn.1006-1959.2022.08.041
文献标志码:
A
摘要:
目的 观察内镜下硬化剂联合组织胶注射治疗门静脉高压（PHT）合并食管胃静脉曲张（GOV）的临床疗效及排胶再出血率。方法 选取2017年1月-2020年12月井冈山大学附属医院消化内科收治的72例PHT合并GOV患者，依据随机数字表法分为对照组与观察组，各36例。对照组行内镜下组织胶注射治疗，观察组则采用内镜下硬化剂联合组织胶注射治疗，比较两组止血成功率、再出血率、静脉曲张缓解效果、组织胶用量、治疗次数、静脉曲张消失时间以及并发症情况。结果 两组止血成功率比较，差异无统计学意义（P＞0.05）；观察组再出血率低于对照组，静脉曲张缓解有效率高于对照组（P＜0.05）；观察组组织胶用量及治疗次数少于对照组（P＜0.05），且静脉曲张消失时间短于对照组（P＜0.05）；两组并发症总发生率比较，差异无统计学意义（P＞0.05），但观察组溃疡发生率高于对照组（P＜0.05）。结论 内镜下硬化剂联合组织胶注射治疗PHT合并GOV止血效果确切，可降低其再出血率，增强静脉曲张的治疗效果，减少组织胶用量与注射次数，缩短治疗时间，且不增加术后并发症风险，但伴有较高的溃疡发生率。
Abstract:
Objective To observe the clinical efficacy of endoscopic sclerotherapy combined with tissue glue injection in the treatment of portal hypertension (PHT) complicated with esophageal and gastric varices (GOV) and the rate of rebleeding after glue drainage.Methods A total of 72 patients with PHT complicated with GOV admitted to Department of Gastroenterology, Affiliated Hospital of Jinggangshan University from January 2017 to December 2020 were selected and divided into control group and observation group according to random number table method, with 36 cases in each group. The control group was treated with endoscopic tissue glue injection, and the observation group was treated with endoscopic sclerotherapy combined with tissue glue injection. The success rate of hemostasis, rebleeding rate, varicose vein remission effect, tissue glue dosage, treatment times, varicose vein disappearance time and complications were compared between the two groups.Results There was no significant difference in the success rate of hemostasis between the two groups (P>0.05). The rebleeding rate in the observation group was lower than that in the control group, and the effective rate of varicose vein relief was higher than that in the control group(P<0.05). The amount of tissue glue and treatment times in the observation group were less than those in the control group (P<0.05), and the disappearance time of varicose veins was shorter than that in the control group(P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05), but the incidence of ulcer in the observation group was higher than that in the control group(P<0.05).Conclusion Endoscopic sclerotherapy combined with tissue gel injection in the treatment of PHT combined with GOV has a definite hemostatic effect, which can reduce the rebleeding rate, enhance the therapeutic effect of varicose veins, reduce the dosage and injection times of tissue gel, shorten the treatment time, and do not increase the risk of postoperative complications, but it has a high incidence of ulcer.

参考文献/References:

[1]路筝,韩晶晶,于晓莉,等.肝硬化门静脉高压食管胃静脉曲张出血二级预防后再出血的临床特征[J].临床肝胆病杂志,2020,36(8):1747-1752.[2]郭依心,李之印,叶月芳,等.内镜下硬化剂联合组织胶治疗食管胃底静脉曲张76例疗效分析[J].中国实用内科杂志,2021,41(5):421-423,427.[3]林毅军,马佳丽,周玉玲,等.幽门螺杆菌感染为胃静脉曲张组织胶注射治疗后排胶出血的可能保护因素[J].肝脏,2018,23(2):118-120.[4]罗添成,黄晓铨,夏睿琦,等.不明原因门脉高压食管胃静脉曲张患者的临床病理特征与内镜治疗[J].中国医师杂志,2021,23(3):324-327,332.[5]赵倩,和水祥,刘亚萍,等.内镜下套扎、硬化剂及组织胶栓塞联合治疗食管胃底静脉曲张出血的临床研究[J].临床和实验医学杂志,2021,20(3):279-282.[6]李敏,史俪露,陈慧.内镜下曲张静脉硬化剂注射术和食管静脉曲张套扎术治疗急性食管静脉曲张的疗效比较[J].现代消化及介入诊疗,2020,25(12):1649-1651.[7]徐小元,丁惠国,贾继东,等.肝硬化门静脉高压食管胃静脉曲张出血防治指南(2015)[J].中华胃肠内镜电子杂志,2015,2(4):1-21.[8]叶营,孙相钊,蔡春调,等.内镜联合药物诊治肝硬化食管胃底静脉曲张破裂出血的疗效及再出血危险因素研究[J].海南医学,2017,28(3):374-378.[9]吴捷,王立届.内镜下套扎联合硬化术应用于肝硬化食管静脉曲张出血患者中的疗效观察[J].浙江创伤外科,2020,25(3):426-427.[10]王广川,黄广军,陈功海,等.球囊辅助下经皮经肝曲张静脉组织胶栓塞治疗孤立胃底静脉曲张[J].中华消化病与影像杂志(电子版),2019,9(2):55-60.[11]王艺霖.肝硬化门脉高压症并食管胃静脉曲张微创治疗的临床观察研究[J].中外医学研究,2020,18(17):120-122.[12]王亮,陈永忠,仝亚林.内镜下1型食管胃静脉曲张组织胶注射术与套扎术临床疗效的回顾性分析[J].河南医学研究,2020,29(8):1359-1362.[13]蓝考,丁家浩,赖斯杨,等.内镜下套扎联合内镜下硬化剂注射治疗对肝硬化食管胃底静脉曲张患者止血成功率及复发率的影响[J].实用医技杂志,2020,27(3):277-279.[14]杨焕英.内镜下套扎序贯硬化剂注射治疗食管静脉曲张破裂出血的效果观察[J].淮海医药,2020,38(1):31-33.[15]李振涛.内镜下套扎联合硬化剂注射治疗乙肝肝硬化并食管胃底静脉曲张出血的效果[J].临床医学,2019,39(10):58-60.[16]丹珠永吉,刘芝兰,禄艳艳,等.内镜下序贯套扎和硬化剂治疗肝硬化并发食管胃底静脉曲张破裂出血患者疗效及对血流动力学的影响对比研究[J].实用肝脏病杂志,2019,22(5):692-695.[17]陈丽萍.内镜下套扎与硬化剂联合组织胶注射治疗食管胃底静脉曲张破裂出血的效果观察[J].基层医学论坛,2019,23(14):2056-2057.[18]陈彩霞,胡藻.内镜下硬化剂联合组织胶治疗食管胃底静脉曲张破裂出血后早期再出血的危险因素研究[J].国际消化病杂志,2018,38(6):397-401.[19]张海涛,邓敏,孙梦晗,等.内镜下硬化剂联合组织粘合剂治疗肝硬化食管胃底静脉曲张破裂出血的临床疗效[J].现代消化及介入诊疗,2018,23(4):455-458.[20]侯运萌,向慧玲.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[J].中国内镜杂志,2015,21(7):673-679.

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更新日期/Last Update: 1900-01-01