内镜下静脉曲张套扎术治疗老年肝硬化合并食管静脉曲张出血患者的临床观察

Effect of Endoscopic Esophageal Variceal Ligation on Esophageal Variceal Bleeding in the Elderly with Hepatic Cirrhosis

目的观察内镜下静脉曲张套扎术(EVL)治疗老年肝硬化合并食管静脉曲张出血患者的临床疗效。方法选取120例老年肝硬化合并食管静脉曲张出血(EVB)患者为研究对象,根据不同的治疗方式分为观察组和对照组,观察组62例,对照组58例。观察组给予内镜下静脉曲张套扎术治疗,对照组给予内科药物治疗,比较2组的临床疗效、并发症发生情况和1年生存率。结果观察组临床有效率显著高于对照组(98.39%vs 41.38%,P<0.05);观察组有异物感、恶心和呕吐等轻微不良反应,术后自行缓解,无严重手术并发症;观察组迟发性出血发生率显著低于对照组(14.52%vs 60.34%,P<0.01);观察组患者1年生存率显著高于对照组(77.12%vs 43.10%,P<0.01)。结论内镜下静脉曲张套扎术治疗老年肝硬化合并食管静脉曲张出血的临床疗效比较显著,安全性高,具有一定的临床应用价值。

Objective To observe the clinical effect of endoscopic esophageal variceal ligation （EVL） on esophageal variceal bleeding （EVB） in the elderly with hepatic cirrhosis. Methods 120 elderly with hepatic cirrhosis combined with EVB were selected and divided into 2 groups： observation group （n=62） and control group （11=58）; endoscopic EVL was performed on patients in observation group while medication was administrated to patients in control group; a comparative study of the clinical effect, occurrence of complications and 1-year survival between the 2 groups was made. Results The clinical effect in observation group was much superior to that in control group （98.39% vs 41.38%, P〈0.05）; slight adverse reactions including foreign body sensation, nausea and vomiting were found in patients in observation group while the symptoms were self-relieved after operation, and no serious complication occurred; the occurrence of delayed bleeding in observation group was obviously lower than that in control group （14.52% vs 60.34%, P〈0.01）; the 1-year survival in observation group was greatly higher than that in control group （77.12% vs 43.10%, P〈0.01）. Conclusions Endoscopic EVL is of obvious clinical effect on EVB in the elderlv with henatic cirrhosis, it is safe and worthy of wider clinical application.