摘要
目的探讨内镜下胃底静脉内注射组织胶联合聚桂醇治疗肝硬化食管胃底静脉曲张(EGV)的应用价值。方法回顾性分析197例肝硬化EGV患者的临床资料。根据治疗方式分为联合聚桂醇组(采用胃底静脉内注射组织胶联合聚桂醇治疗)72例、单纯组织胶组(采用胃底静脉内注射单纯组织胶治疗)125例。比较两组临床疗效、治疗次数和间隔时间、治疗前后门静脉血流动力学变化、并发症发生情况、治疗费用和住院时间。结果两组止血成功率、死亡率差异均无统计学意义(均P>0.05),但联合聚桂醇组术后3个月、6个月、12个月、24个月时的再出血率均低于单纯组织胶组,再次治疗率低于单纯组织胶组(均P<0.05)。治疗后联合聚桂醇组门静脉血管内径、脾静脉血管内径均较治疗前减小,而单纯组织胶组治疗后门静脉血管内径、脾静脉血管内径、脾脏厚度均较治疗前增加(均P<0.05)。联合聚桂醇组内镜治疗费用、住院总费用均低于单纯组织胶组(均P<0.05)。结论与内镜下胃底静脉内注射单纯组织胶治疗相比较,内镜下胃底静脉内注射组织胶联合聚桂醇治疗肝硬化EGV疗效确切,其再出血率、再次治疗率、治疗费用及住院费用更低,值得推广应用。
Objective To explore the application value of endoscopic intravenous injection of tissue glue combined with lauromacrogol in gastric fundus for treating esophageal and gastric fundal varices(EGV) secondary to cirrhosis.Methods The clinical data of 197 patients with EGV secondary to cirrhosis were retrospectively analyzed.According to the treatment methods,72 patients were allocated to combined lauromacrogol group(treated with intravenous injection of tissue glue and lauromacrogol in gastric fundus) and 125 patients to simple tissue glue group(treated with intravenous injection of tissue glue alone in gastric fundus).The clinical efficacy,therapeutic frequency and interval time,portal hemodynamics change before and after treatment,the incidence of complication,as well as hospitalization expense and hospital stay were compared between the two groups.Results There were no statistically significant differences in the success rate of hemostasis and mortality rate between both groups(all P>0.05),however the combined lauromacrogol group had lower re-bleeding rates at 3,6,12 and 24 months after operation and a lower re-treatment rate as compared with the simple tissue glue group(all P<0.05).In comparison with pre-therapy,the postthepapeutic inner diameters of portal vein and splenic vein decreased in the combined lauromacrogol group,and the postthepapeutic inner diameters of portal vein and splenic vein,as well as spleen thickness increased in the simple tissue glue group(all P<0.05).The expense for endoscopy and total cost of hospitalization in the combined lauromacrogol group were less than those in the simple tissue glue group(all P<0.05).Conclusion Compared with the endoscopic intravenous injection of tissue glue in gastric fundus alone,endoscopic intravenous injection of tissue glue combined with lauromacrogol in gastric fundus obtains a definite therapeutic effect on EGV secondary to cirrhosis,and has lower rates of re-bleeding and re-treatment,less treatment cost and hospitalization cost,and is worthy of promotion
作者
孔梦娟
周贤
罗小庆
KONG Meng-juan;ZHOU Xian;LUO Xiao-qing(Department of Gastroenterology,Clinical Medical School of Southwest Medical University,Luzhou 646000,China)
出处
《广西医学》
CAS
2019年第21期2710-2714,共5页
Guangxi Medical Journal
关键词
聚桂醇
组织胶
食管胃底静脉曲张
血流动力学
费用
Lauromacrogol
Tissue glue
Esophageal and gastric fundal varices
Hemodynamics
Cost
