不同方法治疗肝硬化食管胃底静脉曲张破裂出血的临床疗效分析

Clinic analysis of different methods in treatment of gastroesophageal variceal bleeding in cirrhotic patients

目的探讨不同方法治疗肝硬化食管胃底静脉曲张破裂出血的临床疗效。方法回顾性分析肝硬化食管胃底静脉曲张破裂出血患者453例,按胃镜下治疗和保守治疗分为两组,观察两组止血疗效和6个月后曲张静脉疗效;按常规胃镜治疗和急诊胃镜治疗分为两组,观察两组的止血疗效和术后并发症。结果胃镜下治疗组止血疗效和6个月后曲张静脉减轻程度均明显优于保守治疗组,两组比较差异有统计学意义(P均<0.001);常规胃镜治疗组止血疗效和术后并发症均优于急诊胃镜治疗组,两组比较差异有统计学意义(P均<0.001)。结论胃镜下治疗能够有效提高食管胃底静脉曲张破裂出血的止血率,改善患者静脉曲张情况。常规胃镜治疗优于急诊胃镜治疗,且并发症较少。

Objective This paper intends to discuss the clinical significance of different methods in treatment of gastroesophageal variceal bleeding in cirrhotic patients. Methods The clinical manifestation of 453 patients with gastroesophageal variceal bleeding were retrospectively analyzed. The 453 patients were divided into two groups according to endoscopic treatment and conservative treatment, to observe therapeutic effect and gastroesophageal variceal treatment effect after 6 months. They were also divided two groups according to convention of endoscopic treatment and emergency of endoscopic treatment, to observe the hemostatic effect and postoperative complication. Results The hemostasis effect and varicose veins relief of the endoscopic treatment group after 6 months of treatment were significantly better than those of the conservative treatment group. There exists a statistically significant difference between the two groups （P 〈 0. 001 ）. Conclusions Endoscopic treatment can effectively improve the hemostasis rate of esophageal gastric variees bleeding and the varicose veins. The conventional endoscopic treatment is superior to emergency endoscopic treatment with less complications.