两种组织粘合剂对胃底静脉曲张出血疗效的比较

Comparison on the hemostasis effects of two tissue adhesive agents on stomach-fundal varices bleeding

目的观察国产组织粘合剂D-TH液与进口Histoacry(?)液对胃底静脉曲张出血的疗效。方法将重度胃底静脉曲张的172例分为D-TH液组96例,Histoacry(?)液组76例;两组患者均采用三明治夹心法曲张静脉内推注粘合剂治疗1～3次,并随访1年。结果D-TH液组急症止血率100%(41/41),胃底静脉曲张完全消失78例(81．2%),明显减轻18例(18．8%),术后再出血6例(6．3%),消失的曲张静脉再出现7例(7．3%);Histoacry(?)液组分别为100%(33/33)、65例(85．5%)、11例(14．5%)、4例(5．3%)、2例(2．6%),两组间比较无显著性差异(P＞0．05),且两组患者肝肾功能术前后无显著变化,未发生脑、肺栓塞等严重并发症。结论国产组织粘合剂D-TH液对胃底静脉曲张出血疗效可靠、并发症少,与进口的组织粘合剂Histoacry(?)液疗效相接近,且价钱低廉,药源方便。

Objective To observe the hemostasis effects of tissue adhesive agents D-TH and Histoaeryl on stomach-fundal varices bleeding. Methods 172 cases with severe stomach-fundal varices confirmed by endoscopy were divided into 2 groups：D-TH group （96 cases） and Histoacryl group （76 cases）. Sandwiched method was employed for tissue adhesive injection and the follow-up period was 1 year. Results After treatment, the successful hemostasis was 100% for the two groups. The complete eradication, marked reduction, rebleeding and reoccurrence in D-TH group and Histoacryl group were presented as follows： 78 cases（81.2%） vs 65 cases（85.5%）, 18cases（18.8%） vs 11 cases（14.5%）, 6 cases （46.3%） vs 4cases （5.3%） and 7 cases （7.3%） vs 2 cases （2.6%）. There were no significant difference between the two groups （P〉0.05）. The complication found in the two groups was slight abdominal pain but without lung, brain and heart embolism. The hepatic and renal function was not affected. Conclusion Tissue adhesive agent D-TH has good results for treatment of stomach-fundal varices bleeding with few complications. In contrast with Histoacryl, D-TH has similar effects as lower price and lower rate for iniector clot.