| 徐法贞,黄曙,李桂芹,周爱军.内镜下联合治疗肝硬化并发食管胃底静脉曲张破裂出血的效果观察[J].中国临床保健杂志,2019,22(4):542-545. |
| 内镜下联合治疗肝硬化并发食管胃底静脉曲张破裂出血的效果观察 |
| Curative effect of combined therapy under endoscopic for cirrhosis complicated with esophageal and gastric varices |
| 投稿时间：2019-02-22 |
| DOI：10.3969/J.issn.1672-6790.2019.04.029 |
| 中文关键词: 肝硬化 食管和胃静脉曲张 内窥镜检查 |
| 英文关键词: Liver cirrhosis Esophageal and gastric varices Endoscopy 〖FL |
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| 中文摘要: |
| 目的 观察内镜下套扎、组织胶注射等联合治疗食管胃底静脉曲张的疗效及并发症。方法 采用内镜下食管静脉曲张套扎或注射硬化剂联合胃底静脉组织胶注射治疗33例肝硬化并发食管胃底静脉曲张破裂出血患者,观察治疗后根除情况、再出血情况、不良反应及并发症。结果 治疗6个月后复查有56%(18/32)的患者达到静脉曲张根除,44%(14/32) 的患者达到基本消失,随访1年32例患者均未再发消化道出血；治疗前轻度和重度门脉高压性胃病(PHG)的发生率分别为18.2%(6/33)和3%(1/33),6个月后PHG的发生率为42.4%(14/32),其中3例为重度,较治疗前显著增加 (P<0.05)；出现胸痛18例、上腹部不适8例、低热7例,均于1周后完全消失。结论 内镜下套扎或注射硬化剂联合组织胶注射治疗肝硬化并发食管胃底曲张静脉安全有效,但会加重PHG的发生及存在其他并发症。 |
| 英文摘要: |
| Objective To observe the efficacy and complications of endoscopic ligation and tissue glue injection in the treatment of esophageal and gastric varices. Methods Thirty-three liver cirrhosis complicated with esophageal and gastric varices were treated with endoscopic ligation of esophageal varices or sclerosing agent injection combined with gastric fundus vein tissue glue injection. The adverse reactions, complications, and rebleeding after eradication were observed. Results Fifty-six percent (18/32) of the patients with varicose veins were eradicated, 44%(14/32) of varicose veins almost disappeared after 6 months of treatment. The patients were followed up for 1 year without further gastrointestinal bleeding. The incidence of mild and severe portal hypertensive gastropathy (PHG) was 18.2%(6/33) and 3%(1/33) before treatment, respectively. After 6 months, the incidence of mild PHG was 42.4%(14/32), and 3 cases were severe, which was significantly higher than that before treatment (P<0.05). There were 18 cases of chest pain, 8 cases of upper abdominal discomfort and 7 cases of low fever, all of which disappeared completely after 1 week. Conclusion Endoscopic ligation or sclerosing agent injection combined with tissue glue injection for cirrhosis complicated with esophageal and gastric varices is safe and effective, but will aggravate the occurrence of PHG and other complications. |
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