晚期血吸虫病食管静脉曲张破裂不同出血量套扎术的治疗效果

Treatment effect of esophageal variceal ligation with different bleeding amount in 107 cases of advanced schistosomiasis

目的探讨在不同出血量及肝功能状态下,食管曲张静脉套扎术(EVL)治疗食管曲张静脉破裂(EVB)出血的临床治疗效果。方法选择湘岳医院2005年1月至2010年12月收治的晚期血吸虫病并发EVB患者107例,在内科综合治疗基础上给予EVL。结果本组患者107例,肝功能Child分级与食管曲张静脉程度有等级相关关系,相关系数为0.728(P<0.01),与出血量呈正相关关系,相关系数为0.848(t=16.426,P<0.01)。内科治疗+套扎术治疗的有效率为97.87%,单纯内科治疗的有效率仅为12.15%,二者比较差异有统计学意义(P<0.01)。结论肝功能损害越严重食管胃底静脉曲张程度就越大、出血量也越多。内科治疗+套扎术治疗EVB的有效率明显优于单纯内科治疗。

Objective To assess the clinical therapeutic effect of esophageal variceal ligation （EVL） in treatment of esophagus varicosity bursts （EVB） hemorrhage on the different amount of bleeding and liver function. Methods Analysis of upper alimentary canal bleeding in 107 cases of the advanced schistosomiasis, which treated by EVB in subsidiary Xiangyue hospital of Hunan Institute of Parasitic Diseases from Jan -2000 to Dec -2010. Results Child-classification of liver function and esophageal varices have correlation, with the correlation coefficient of 0.728 （P〈0.O1）, and amount of bleeding are positively related, with the correlation coefficient of 0.848 （t = 16.426, P〈0.01 ）. The efficiency of medical treatment plus ligation was 97.87%, while the efficiency of medicine therapy was only 12.15%. Conchmion The more serious of the liver function damage, the more were the esophageal gastric varices and bleeding. Medical treatment plus ligation for treatment of EVB were significantly better than the simple medical treatment.