内镜下套扎、硬化剂单用及联用治疗食管静脉曲张的对比分析

Comparative analysis of endoscopic ligation,hardener alone and combination in treatment of esophageal varices

目的探讨内镜下套扎、硬化剂及二者序贯联合应用治疗食管静脉曲张的临床效果。方法选取玉溪市人民医院收治的194例因肝硬化致食管静脉曲张患者,随机分为套扎组(单独应用套扎)64例、硬化剂组(单独应用硬化剂)65例、联合组(套扎+硬化剂序贯联合应用)65例,对比3组患者的临床治疗效果。结果联合组治疗显效率(72.31%)显著高于套扎组(56.25%)和硬化剂组(52.31%),差异有统计学意义(P<0.05),但3组患者的总有效率差异无统计学意义(P>0.05)。治疗后3组患者的血流速度、血流量较治疗前均显著提高(P<0.05);联合组患者的平均套扎疗程、平均每人套扎环数均显著低于套扎组(P<0.05);联合组的平均硬化剂疗程、平均硬化剂每人用量、平均硬化剂用量均显著小于硬化剂组(P<0.05);硬化剂组患者的术后发热率显著高于联合组和套扎组(P<0.05);套扎组患者的进食异物感发生率显著高于联合组和硬化剂组(P<0.05)。结论内镜下套扎、硬化剂序贯联合应用治疗食管静脉曲张的效果显著,术后并发症发生率更低。

Objective To explore the clinical effect of endoscopic ligation,hardener alone and sequential combination in treatment of esophageal varices. Methods All of 194 cases of esophageal varices caused by liver cirrhosis patients in Yuxi People＇s Hospital of Yunnan Province were randomly divided into ligation group（ ligation alone）,hardening agent group（ hardener alone）,combination treatment group（ ligation ＋ hardener sequential combination）. Clinical effects were compared among three groups. Results The effective rate was significantly higher in combination treatment group（72. 31%） than that in ligation group（56. 25%） and hardener group（52. 31%）,the difference was statistically significant（ P〈0 05）. There was no significant difference in the total effective rate among 3 groups（ P〉0 05）. Blood flow velocity and blood flow volume were significantly improved after treatment than before treatment in 3 groups（ P〈0 05）. The average ligation treatment course and the average person ligation ring were significantly lower in combination treatment group than those in ligation group（ P〈0 05）; the average hardener course,the average per capita amount,hardener average dose were significantly lower in combination treatment group than those in the hardener agent group（P〈0 05）; the rate of postoperative fever was significantly higher in hardener agent group than that in the combination treatment group and ligation group（ P〈0 05）; the incidence of eating foreign body sensation in ligation group was significantly higher than that in the combination treatment group and hardener agent group（ P〈0 05）. Conclusion Clinical effect of ligation ＋ hardener sequential treatment for esophageal varices is good,the complication rate is lower.