食管静脉曲张出血套扎治疗与硬化治疗对比分析

A comparative analysis between endoscopic variceal ligation and tissue adhesive injection in cirrhotic esophageal variceal bleeding

目的比较套扎治疗与硬化治疗肝硬化食管静脉曲张出血的安全性和疗效。方法回顾性分析2010年1月~2014年5月接受治疗的肝硬化食管静脉曲张出血患者临床资料,共77例患者接受了套扎治疗(1组);33例采用了硬化治疗(2组)。分析两组患者治疗次数、2周内因再出血再入院率、2年内再出血率(含2周内再出血)、痊愈率的差异,计量资料采用t检验,计数资料采用c2检验或Fisher确切概率法。结果 1、2组患者接受治疗次数分别为(2.234±0.426)次和(2.909±0.579)次,差异有统计学意义(P=0.000);2周内再出血入院比例分别为5.19%和27.27%,差异有统计学意义(P=0.002);2年内再次出血率分别为6.49%和42.42%,差异有统计学意义(P=0.000);痊愈率分别为88.31%和60.60%,差异有统计学意义(P=0.002)。结论对于食管静脉曲张的患者,套扎治疗比硬化治疗更加安全有效。

Objective The study is aimed to observe security and effect of endoscopic variceal ligation and tissue adhesive injection in cirrhotic esophageal variceal bleeding. Methods Retrospective analysised the clinical data of endoscopic variceal ligation and tissue adhesive injection in cirrhotic esophageal variceal bleeding in January 2010 to May 2016. A total of 77 patients who underwent endoscopic variceal ligation（group 1）; A total of 33 patients who underwent tissue adhesive injection（group 2）; analysised the difference of treatment times, rebleeding rate in 2 weeks or 2years, cure rate between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test or Fisher＇s exact test was used for comparison of categorical data between groups. Results The patients of group 1 had（2.234±0.426）treatment times, rebleeding rate in 2 weeks was 5.19%, rebleeding rate in 2 years was 6.49%, cure rate was 88.31%; the patients of group 2 had（2.909 ± 0.579） treatment times, rebleeding rate in 2 weeks was 27.27%, rebleeding rate in 2 years was 42.42%, cure rate was 60.60%; There were significant differences between the two groups in the treatment times（P=0.000） and rebleeding rate in 2 weeks（P=0.002） and rebleeding rate in 2 years（P=0.000） and cure rate（P=0.002）. Conclusion Endoscopic variceal ligation had more security and effect than tissue adhesive injection in cirrhotic esophageal variceal bleeding.