经内镜三明治法联合注射聚桂醇及组织胶治疗胃静脉曲张

THE SANDWICH APPROACH OF COMBINED INJECTION OF TISSUE ADHESIVE AND LAUROMACROGOL ON GASTRIC VARICES

目的探讨聚桂醇联合组织胶三明治法注射治疗胃静脉曲张的疗效,分析曲张静脉复发的相关危险因素。方法选择沂水中心医院2012年6月至2014年9月收治肝硬化合并胃静脉曲张出血患者65例,随机分为3组,分别行血管内注射聚桂醇、组织胶及二者三明治法联合注射,观察治疗过程中的即时出血率,随访观察有效率,记录复发率,分析复发的相关危险因素。结果组织胶注射剂及三明治法联合注射的安全性高,治疗过程无出血患者,三组治疗有效率均较高,分别为94.4%、89.5%和93.1%,各组之间无明显差异性,联合治疗组复发率为14.3%,较其他两组明显降低,单因素分析显示,肝功能分级与静脉曲张复发有关,肝功能越差,复发率越高。结论聚桂醇联合组织胶三明治法联合注射治疗可明显降低复发率,肝功能Child-Pugh分级是静脉曲张复发的危险因素。

Objective To explore the therapeutic effects of the sandwich approach of combined injection of tissue adhesive and lauromacrogol on gastric varices and to analyze the related risk factors of the recurrence of varices .Methods A total of 65 liver cirrhosis patients with gastric varices treated in this hospital from June , 2012 to September ,2014 were randomly divided into three groups and were given intravascular lauromacrogol injection ,tissue adhesive injection and the sand‐wich approach of combined injection of both respectively .The Immediate bleeding rate ,the follow‐up ef‐fective rate and the recurrence rate were recorded and the risk factors of recurrence were analyzed .Results The effective rate in the three groups were 94 .4% ,89 .5% and 93 .1% respectively .No significant differ‐ences were found between them .The recurrence rate was 14 .3% in the combined injection group ,lower than those in other two groups .The single factor analysis showed that the Child‐Pugh grading of liver function was related to the recurrence of varices ,and the recurrence rate of varices rose as the liver func‐tion declined .Conclusion The sandwich approach of combined injection of tissue adhesive and lauromacro‐gol can obviously reduce the recurrence rate of varices and Child‐Pugh grading is a risk factor of the recur‐rence of varices .