Short-term efficacy of EVL, EIS, and TAI in treatment of esophageal variceal bleeding
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摘要: 目的观察肝硬化食管静脉曲张破裂出血患者行内镜下套扎、硬化剂及组织胶注射治疗后食管静脉曲张程度、红色征及门静脉高压性胃病的变化。方法回顾性分析本院2011年9月-2013年9月收治的75例食管静脉曲张破裂出血患者,行首次内镜下套扎、硬化剂或组织胶注射治疗。24周后复查胃镜,对比治疗前后曲张食管静脉的数目与直径、红色征及门静脉高压性胃病在内镜下的改变。组内治疗前后的比较采用配对t检验,率的比较采用卡方检验。结果治疗后曲张食管静脉的数目及直径均小于治疗前[(3.08±0.96)vs(3.75±0.60),t=5.26,P<0.05;(1.05±0.46)cm vs(1.49±0.26)cm,t=9.84,P<0.05)],差异均有统计学意义。红色征的发生率较治疗前降低,差异有统计学意义(26.67%vs 57.33%,χ2=14.48,P<0.05)。治疗后门静脉高压性胃病虽有所好转,但差异无统计学意义(70.67%vs 72.00%,χ2=0.03,P>0.05)。结论内镜下套扎、硬化剂及组织胶注射治疗食管静脉曲张破裂出血的方法安全、有效。Abstract: Objective To observe the changes in degree of varices, red signs, and portal hypertensive gastropathy in liver cirrhosis patients with esophageal variceal bleeding (EVB) after endoscopic variceal ligation ( EVL) , endoscopic injection sclerotherapy ( EIS) , and tissue adhesive injection (TAI) . Methods A retrospective analysis was performed on 75 patients with EVB, who were initially treated with EVL, EIS, or TAI in our hospital from September 2011 to September 2013. At 2- 4 weeks after operation, gastroscopy was performed to evaluate the changes in the number and diameter of varices, red signs, and portal hypertensive gastropathy. Within- group comparison was made by paired t test, and comparison of rates was made by chi- square test. Results The number and diameter of varices decreased significantly after endoscopic therapy (3. 08 ± 0. 96 vs 3. 75 ± 0. 60, t = 5. 26, P < 0. 05; 1. 05 ± 0. 46 cm vs 1. 49 ± 0. 26 cm, t = 9. 84, P < 0. 05) .The rate of red signs also decreased significantly after operation (26. 67% vs 57. 33%, χ2= 14. 48, P < 0. 05) . However, the rate of portal hypertensive gastropathy decreased nonsignificantly after treatment (70. 67% vs 72. 00%, χ2= 0. 03, P > 0. 05) . Conclusion EVL, EIS, and TAI are effective and safe in liver cirrhosis patients with EVB.
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