食管胃底静脉曲张内镜下治疗的疗效评价

Assessment of the effects after endoscopic treatment for esophageal and gastric varices

目的评价单纯内镜下硬化治疗(EIS)和内镜下套扎与硬化序贯治疗(ELIS)的疗效比较分析。方法收集包头医学院第二附属医院2011年4月至2014年5月收治的179例肝硬化伴食管胃底静脉曲张破裂出血行内镜下治疗的患者进行回顾性分析,按照治疗方式分为两组:EIS组81例,ELIS组98例。观察治疗终末后静脉曲张消失率、硬化剂用量及治疗次数、静脉曲张复发率及并发症等情况。结果两组患者静脉曲张消失率、随访期内复发率相似,无显著性差异。而ELIS组较EIS组治疗次数明显减少,平均硬化剂用量少,并发症发生率低,且均有显著性差异。结论和EVL相比,EISL在治疗肝硬化伴食管胃底静脉曲张破裂出血复发率更低,并发症更少,治疗周期更短。

Objective To compare the efficacy and complications of endoscopic variceal sclerotherapy with endoscopic variceal ligation combined with sclerotherapy for gastroesophageal variceal bleeding. Methods Cliniacal date of 179 patients with liver cirrhosis and gastroesophageal variceal bleedingwere analyzed in our hospital from January 2011 to May 2014. According to the different treatment methods,the cases were divided into two groups： endoscopic variceal injection sclerotherapy group（ EIS）with 81 cases,and endoscopic variceal ligation combined with injection sclerotherapy（ ELIS） with 98 cases.Results The disappearance rate of varicesin two groupswas similar. The treatment frequencies and dose of sclerotic were significantly less in ELIS group than EIS group. There were no statistical differences between two groups in the re-bleeding rate and mortality. The occurrence of complications in ELIS group were less than that in EIS group,especial in the esophageal stricture. Conclusions Compared with EIS,ELIS is with lower recurrence rate,higher security and shorter treatment period.