密集套扎治疗肝硬化重度食管静脉曲张的效果观察

The observation of the therapeutic effects of liver cirrhosis with severe esophageal varices under dense ligation

目的观察密集套扎治疗肝硬化重度食管静脉曲张的效果。方法选取2014年7月至2017年6月于郑州大学第一附属医院接受内镜下套扎治疗的114例肝硬化重度食管静脉曲张患者为研究对象,根据套扎方式分为A组(密集套扎,69例)和B组(非密集套扎,45例),观察两组的治疗效果。结果 A组平均首次套扎个数[(13. 32±2. 21)个]多于B组[(5. 98±1. 16)个],差异有统计学意义(P <0. 05);治疗4周后复查,A组治愈率(18. 8%)和总有效率(92. 7%)高于B组(6. 7%、71. 1%),差异有统计学意义(P <0. 05)。A组平均治疗次数[(2. 25±0. 85)次]少于B组[(2. 89±0. 88)次],差异有统计学意义(P <0. 05)。A组术后早期再出血率(11. 6%)和B组(15. 6%)比较,差异无统计学意义(P> 0. 05)。两组不良反应发生率比较,差异无统计学意义(P> 0. 05)。随访6个月,A组静脉曲张复发率为36. 2%,B组为40. 0%,差异无统计学意义(P> 0. 05)。结论密集套扎治疗重度食管静脉曲张安全有效,与非密集套扎治疗相比,可降低静脉曲张程度,减少套扎次数。

Objective To observe the therapeutic effects of dense ligation in the treatment of severe esophageal varices. Methods A total of 114 patients with severe esophageal varices who underwent endoscopic ligation treatment from July 2014 to June 2017 in the First Affiliated Hospital of Zhengzhou University were selected in the study. The patients were divided into group A （dense ligation, 69 patients） and group B （non -dense ligation, 45 patients） according to different therapeutic methods. Thetherapeutic effects of two groups were observed. Results The average ligation number for first treatment in group A （ 13.32 ±2. 21 ） was higher than that in group B （5. 98±1.16）, and the difference was statistically significant （P 〈0. 05）. After 4 weeks of first treatment, the cure rate （ 18.8% ） and total effective rate （92. 7% ） of group A were higher than that of group B （6. 7% and 71.1% ）, and the difference was statistically significant （ P 〈 0. 05 ）. The average number of treatment （ 2.25 ± 0. 85 ） in group A was less than that in group B （2. 89 ±0. 88）, and the difference was statistically significant （P 〈0. 05）. There was no statistically significant difference in the rate of early rebleeding between group A （11.6% ） and group B （15.6%） （P 〉 0. 05 ）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （ P 〉 0. 05）. After 6 months of follow - up, the recurrence rate of esophageal varices was 36. 2% in group A and 40. 0% in group B, and there was no statistically significant difference （ P 〉 0. 05 ）. Conclusion Dense ligation in the treatment of severe esophageal variees is safe and eft）etive. Compared with non intensive ligation, dense ligation can reduce the degree of esophageal variees and reduce the treatment times.