组织胶联合聚桂醇治疗胃底静脉曲张的疗效

Efficacy of tissue adhesive combined with lauromacrogol in treatment of gastric varices

目的:探讨组织胶联合聚桂醇治疗对胃底静脉曲张(gastric variceal,GV)的临床疗效.方法:回顾性分析我院2010-08/2014-02间因肝硬化伴胃底静脉曲张破裂出血行内镜下治疗的患者临床资料.行组织胶联合聚桂醇注射治疗(GIS组)的患者101例,行单纯组织胶治疗(Histoacryl组)的患者70例,比较两组患者的临床止血疗效、GV改善情况、再出血情况及临床不良反应.结果:两组止血成功率均为100%.GIS组术后随访1-24 mo(7.47 mo±6.04 mo),GV缓解率为45.54%,消失率为27.72%,总体有效率为73.26%;Histoacryl组术后随访1-26 mo(12.17mo±8.01 mo),GV缓解率为28.57%,消失率为24.29%,总体有效率为52.86%,GIS组GV有效率高于Histoacryl组,有统计学意义(P<0.01).GIS组平均缓解时间(3.67 mo±4.24 mo)早于Histoacryl组(7.22 mo±7.11 mo),有统计学意义(P<0.05).GIS组、Histoacryl组术后总体再出血率分别为22.77%、34.29%,差异无统计学意义(P>0.05).GIS组平均再出血时间(2.50mo±2.69 mo)早于Histoacryl组(5.56 mo±5.26mo),有统计学意义(P<0.05).结论:组织胶联合聚桂醇治疗在改善GV方面疗效优于单纯组织胶.联合治疗并不增加术后再出血率,但可使术后再出血时间提前.

AIM： To assess the clinical effect of tissue adhesive combined with lauromacrogol on gastric varices. METHODS： The clinical data of patients who had a history of gastric variceal bleeding due to liver cirrhosis and underwent endoscopic treatment from August 2010 to February 2014 were analyzed retrospectively. Tissue adhesive combined with lauromacrogol （GIS group） was performed in 101 cases, and tissue adhesive only （Histoacryl group） was used in 70 cases. The hemostatic effects, improvement of gastric varices,conditions of rebleeding and adverse reactions were compared between the two groups. RESULTS： The hemostatic rate in both groups was 100%. The follow-up period was 1-24 mo （7.47 mo ± 6.04 mo） for the GIS group. The remission rate of gastric varices was 45.54%, the eradication rate of gastric varices was 27.72%, and the total effective rate was 73.26% in the GIS group. The follow-up period was 1-26 mo （12.17 mo ± 8.01 mo） in the Histoacryl group. The remission rate of gastric varices was 28.57%, the eradication rate of gastric varices was 24.29% and the total effective rate was 52.86% in the Histoacryl group. The efficacy was significantly better in the GIS group than in the Histoacryl group （P 〈 0.01）. The mean time to remission in the GIS group （3.67 mo ± 4.24 too） was significantly shorter than that in the Histoacryl group （7.22 mo ± 7.11 mo） （P 〈 0.05）. The rebleeding rate had no statistical difference between the GIS group （22.77%） and Histoacryl group （34.29%） （P 〉 0.05）. The mean time to rebleeding in the GIS group （2.50 mo ± 2.69 mo） was significantly shorter than that in the Histoacryl group （5.56 mo± 5.26 mo） （P 〈 0.05）. CONCLUSION： Tissue adhesive combined with lauromacrogol is more effective than Histoacryl in improving gastric varices. Although the combination therapy did not increase the rebleeding rate, the mean time to rebleeding was earlier.