内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张的近远期疗效比较

内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张的近远期疗效比较庞红全;杨帆;余瑞金【摘要】Objective To investigate the short-term and long-term effect of endoscopic injection by lau-romacrogol and tissue adhesive in the treatment of esophageal and gastric varices in patients with cirrhosis. Methods A retrospective analysis, which including 64 patients diagnosed GV from April 2013 to April 2014 in our hospital was conducted. Randomization system of medical research RandA1.0 was used to divide them into study group (n=32) and control group (n=32). The study group was treated with lauromacrogol and tis-sue adhesive under endoscopic treatment, while the control group only used tissue adhesive under endoscopic treatment. The relief of varicose veins, tissue glue discharge and local proliferation conditions, rebleeding rate, effective rate and complications were compared by follow-up endoscopy in 1 month, 3 months and 6 months respectively after the treatment. Results After 1 month of treatment, the total effective rate was 93.75%in the study group and 90.62%in the control group, which has no significant difference (P>0.05). However, the total effective rate was 93.75%and84.37%respectively after 3 and 6 months treatment in study group, while that was 71.87%和56.25%in control group, the difference was significant (P<0.05). There was no significant dif-ference in the recently rebleeding rate between the two groups (P>0.05). There were significant differencesin achieve hemostasis rate, long-term rebleedding rate, effective rate and incidence of complications between two groups (P<0.05). Patients in the study group got markedly improvement of esophageal and gastric varices af-ter treatment, however, the control group had no obvious effect even became worse (P<0.05). Conclusions Endoscopic injection of lauromacrogol and tissue adhesive in the treatment of liver cirrhosis with esophageal and gastric varices is effective, with high rate of achieve hemostasis, obvious improvement of varicose vein, depressed rate of long-term rebleeding and incidence of complications, which could contribute to the prognosis&nbsp;of patients and was worth popularizing.%目的：探讨内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张的近远期疗效。

方法回顾性分析2013年4月至2014年4月四川达州市中心医院消化科确诊GV患者64例，随机分为研究组（n=32）和对照组（n=32），研究组采用聚桂醇与组织黏合剂于内镜下治疗，对照组采用单纯组织胶联合内镜治疗，分别于1、3、6个月复查胃镜，观察治疗前后静脉曲张的缓解情况，组织胶排出情况和局部增生状况，分析再出血发生率、静脉曲张治疗有效率与并发症。

结果治疗后1个月研究组食管胃底静脉曲张总有效率为93.75%，对照组为90.62%，组间比较无明显差异（P>0.05）；而治疗后3个月和治疗后6个月研究组总有效率为93.75%和84.37%，对照组分别为71.87%和56.25%，组间比较具有显著性的差异（P<0.05）。

两组患者近期再出血率比较差异无显著性意义（P>0.05）；两组在止血成功率、远期再出血率、静脉曲张治疗有效率以及并发症发生率方面比较存在显著性差异（P<0.05）。

研究组患者经过治疗后，食管、胃底静脉曲张改善显著，对照组患者改善效果不明显或加重，组间比较具有显著性的差异（P<0.05）。

结论内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张疗效确切，具有止血成功率高，静脉曲张改善显著，降低远期再出血及并发症的发生率，从而有助于患者预后恢复，值得推广应用。

【期刊名称】《现代消化及介入诊疗》【年(卷),期】2016(021)004【总页数】4页(P527-530)【关键词】内镜下;聚桂醇;组织胶;食管胃底静脉曲张【作者】庞红全;杨帆;余瑞金【作者单位】635000 四川达州市中心医院消化科;635000 四川达州市中心医院消化科;635000 四川达州市中心医院消化科【正文语种】中文【Abstract】Objective To investigate the short-term and long-term effectof endoscopic injection by lauromacrogol and tissue adhesive in the treatment of esophageal and gastric varices in patientswith cirrhosis. M ethods A retrospectiveanalysis，which including 64 patientsdiagnosed GV from April2013 to April2014 in ourhospitalwas conducted.Randomization system ofmedical research RandA1.0wasused to divide them into study group（n=32）and controlgroup（n=32）.The study group was treated w ith lauromacrogoland tissue adhesive underendoscopic treatment，while the controlgroup only used tissue adhesive underendoscopic treatment.The relief of varicose veins，tissue glue discharge and localproliferation conditions，rebleeding rate，effective rate and complicationswere compared by follow-up endoscopy in 1month，3monthsand 6months respectively after the treatment.Results After1month of treatment，the totaleffective ratewas93.75%in the study group and 90.62%in the controlgroup，which hasno significantdifference（P＞0.05）.However，the total effective ratewas93.75%and 84.37%respectively after 3 and 6months treatment in study group，while that was71.87%和56.25%in controlgroup，the differencewas significant（P＜0.05）.Therew asno significantdifference in the recently rebleeding ratebetween the two groups（P＞0.05）.Therewere significant differences in achieve hemostasis rate，long-term rebleedding rate，effective rate and incidence of comp licationsbetw een tw o groups（P＜0.05）.Patients in the study group gotmarkedly improvementof esophagealand gastric varices after treatment，how ever，the control group had no obvious effect even became w orse（P＜0.05）.Conclusions Endoscopic injection of lauromacrogol and tissue adhesive in the treatmentof liver cirrhosiswith esophageal and gastric varices iseffective，with high rateof achieve hemostasis，obvious improvementof varicose vein，depressed rate of long-term rebleeding and incidence of com plications，which could contribute to the prognosisof patientsandwasworth popularizing.【Key w ords】Endoscopic；Lauromacrogol；Tissue adhesive；Esophagealand gastric varices有关研究表明［1］，门静脉高压症多数由肝硬化发展变化引起的，胃底静脉曲张（GV）患者大概50%由肝硬化诱发所致，胃底静脉曲张破裂出血（GVB）是一种肝硬化肝功失代偿期严重并发症，其出血率高、并发症多以及治疗困难，是消化道危急重症之一。