食管静脉曲张内镜下套扎及硬化等联合治疗的比较观察

A comparative observation of esophageal varicosis treated by ligation,sclerotherapy or its combination

目的对比观察内镜下套扎(EVL)后追加硬化剂注射(EV S)即EVL+EV S联合序贯治疗与单纯EVL及EV S治疗食管静脉曲张的疗效。方法120例慢性乙型病毒性肝炎后肝硬化并食管静脉曲张破裂出血(EVB)患者随机分成三组,各为46例、38例、36例分别接受EVL、EV S、EVL+EV S治疗。对三组治疗后急诊止血率、静脉曲张消失率、再发出血率、静脉曲张复发率、总并发症发生率进行对比。结果三组急诊止血率、静脉曲张消失率均在90%以上,比较无显著差异(P>0.05),再发出血率、静脉曲张复发率三组比较,EVL组明显高于EV S及EVL+EV S组,总并发症发生率三组中EV S组明显高于EVL及EVL+EV S组(P<0.05)。结论EVL+EV S疗效优于单纯EV S、EVL,是目前治疗EVB较理想的方法。

Objective To observe the effect of esophageal variceal ligature plus sclerotherapy on esophageal varices compared with that of esophageal variceal ligature or esophageal variceal selerotherapy alone. Methods 120 patients of cirrhosis with chronic type B viral hepatitis and esophageal variceal bleeding were divided into three groups randomly ： 46 in the esophageal variceal ligation （EVL） group, 38 in,he esophageal variceal sclerothrapy （EVS） group,and 36 in the esophageal variceal ligation plus sclerothrapy （EVL＋EVS）. The controlling active bleeding ,disappearence of esophageal varices ,recurrence of bleeding ,recurrence of esophageal varices were observed in each group. Results There were no statistical differences in the three groups for the controlling active bleeding and disappearrance of esophageal varices（P〉0.05）. The recurrence of bleeding and esophageal varices were higher significantly in EVL group than that in EVS or EVL＋EVS. The totol complications were higher in EVS than that in the other groups（P 〈0. 05）. Conclusion EVI. plus EVS rather than EVI. or EVS alone is an optimal method for the treatment of EVB.