内镜密集与非密集套扎治疗重度食管静脉曲张256例

Efficacy of dense endoscopic ligation in treating severe esophageal varices: an analysis of 256 cases

目的:观察内镜密集套扎治疗重度食管静脉曲张的效果.方法:肝硬化门脉高压患者256例,分为2组:A组为密集套扎组130例,B组为非密集套扎组(标准组)126例.分组标准以一次套扎圈<6个为非密集套扎组,>8个为密集套扎组.采用6连发套扎器行内镜治疗.结果:A组首次平均每例患者结扎10.9个点,首次结扎2wk后复查食管静脉曲张基本治愈(曲张静脉基本消除率)者39例,显效者有43例,有效者20例,无效者7例,总有效率93.58%.平均结扎1.6次.B组食管静脉曲张基本治愈(曲张静脉基本消除率)者7例,显效者有58例,有效者40例,无效者7例,总有效率93.75%,平均结扎2次.结论:食管静脉曲张采用密集套扎法进行连续EVL治疗,静脉曲张消失率高,减少套扎次数,是有效的治疗食管静脉曲张的可靠方法.

AIM： To observe the efficacy of endoscopic variceal ligation. METHODS： Two hundred and fifty six cirrhotic patients with severe esophageal varices were randomly divided into 2 groups： dense ligation group （goup A, n = 130） and non- dense ligation group （group B, n = 126）. Criteria for grouping were that collar of loop ligature 〉 8 was taken as dense ligation and collar of loop ligature 〈 6 as non-dense ligation. Six shooter multi-band ligators were used for endoscopy. RESULTS： In group A, average ligature for fi rst ligation was 10.9 ligature points for each patient. Two weeks after first ligature, 39 patients were basically cured （varicose vein was essentially cured）, 43 patients were greatly improved, 20 patients responded to some degree, and 7 patients did not respond to the treatment, resulting in a total effective rate of93.58% and an average ligation of 1.6 times. In group B, 7 patients were basically cured （varicose vein was basically cured）, 58 patients were greatly improved, 40 patients responded to some degree, and 7 patients did not respond to the treatment, resulting in a total effective rate of 93.75% and an average ligation of two times. CONCLUSION： Successive endoscopic variceal ligation, which brings about high disappearance rate of esophageal varices and reduced ligation frequency, is an effective and reliable approach to esophageal varices.