内镜下曲张静脉套扎联合部分脾栓塞术对食管静脉曲张的疗效

Efficacy of endoscopic variceal ligation combined with partial splenic embolization for the treatment of esophageal varices

目的:研究内镜套扎联合部分脾栓塞术对食管静脉曲张(esophageal variceal,EV)的疗效.方法:比较应用内镜下静脉曲张套扎(endosco-pic variceal ligation,EVL)联合部分脾栓塞术(partial splenic embolization,PSE)与单纯应用内镜套扎对EV的根治率、复发率及再出血率.结果:第6、12月EVL联合PSE组静脉曲张根治率显著高于单纯套扎组(83.9%vs60.5%,71.0%vs45.9%,P=0.033,0.038)、复发率也显著低于单纯套扎组(12.9%vs34.2%,22.6%vs48.6%,P=0.041,0.026);第12月联合组静脉曲张再出血率明显低于单纯套扎组(9.7%vs32.4%,P=0.024).结论:内镜套扎联合部分脾栓塞术治疗EV中远期疗效较单纯内镜套扎更佳,有更高的根治率及较低的复发率、再出血率.

AIM： To assess the efficacy of endoscopic varice al ligation combined with partial splenic emboli zation for the treatment of esophageal varices. METHODS： The patients were divided into two groups, those who underwent endoscopic variceal ligation （EVL） combined with partial splenic embolization （PSE） and endoscopic vari ceal ligation only. The cure rate, recurrence rate, and rebleeding rate of esophageal varices werecompared between the two groups.RESULTS： At 6 and 12 mo after treatment, the cure rate was significantly higher （83.9% vs 60.5%, 71.0% vs 45.9%, P = 0.033, 0.038） and the recurrence rate was significantly lower （12.9% vs 34.2%, 22.6% vs 48.6%, P = 0.041, 0.026） in the combination group than in the EVL group. At 12 mo after treatment, the rebleeding rate was sig nificantly lower in the combination group than in the EVL group （9.7% vs 32.4%, P = 0.024）.CONCLUSION： The medium and long-term ef ficacy of endoscopic variceal ligation combined with partial splenic embolization for esophageal varices is better than that of endoscopic variceal ligation alone, and the combination treatment was associated with a higher cure rate and low er recurrence rate and rebleeding rate.