内镜下套扎和组织胶注射分别治疗食管和胃底静脉曲张患者的临床观察

The clinical observation of endoscopic variceal ligation and tissue glue injection therapy in the treatment of patients with esophageal and gastric fundal varices

目的探讨内镜下套扎和组织胶注射治疗食管胃底静脉曲张的疗效和价值。方法予184例重度食管静脉曲张患者内镜下套扎治疗，其中32例伴胃底静脉曲张者还进行内镜下组织胶注射治疗。随访6个月并观察内镜下套扎和组织胶注射治疗的疗效和并发症。结果内镜下套扎治疗重度食管静脉曲张的有效率为71．74％（132／184），急诊止血率为95．00％（57／60），并发症（食管套扎部位瘢痕狭窄需行扩张治疗）发生率为2．17％（4／184）。内镜下组织胶注射治疗胃底静脉曲张的有效率为100％（32／32），并发症（注射部位难治性溃疡7例，其中难治性溃疡并出血2例）发生率为21．88％（7／32）。均无穿孔、重度感染并发症发生。结论内镜下套扎和组织胶注射治疗食管和胃底静脉曲张疗效良好。

Objective To explore the therapeutic effects and value of endoscopic variceal ligation and tissue glue injection therapy in esophageal and gastric fundal varices. Methods 184 patients with severe esophageal varices underwent endoscopic variceal ligation treatment, and 32 cases of those accompanied with gastric fundal varices were treated with tissue glue injection therapy. All patients were followed-up for 6＂ months to observe the therapeutic effects and complication of endoscopic variceal ligation and tissue glue injection therapy. Results The effective rate of endoscopic variceal ligation in severe esophageal varices was 71.74~ （132/184）, the rate of acute hemostasis was 95.00 ~//0 （57/60） and the rate of complication was 2.17 % （4/184）. The effective rate of tissue glue injection in gastric fundal varices was 100~ （32/32） and the rate of complication was 21.88% （7/32） （7 cases with refractory ulcers in injection site, 2 of refractory ulcers cases with bleeding）. There was no perforation and severe infection complications. Conclusion Endoscopic variceal ligation and tissue glue injection therapy have good therapeutic effects in esophageal and gastric fundal varices.