食管静脉曲张择期内镜下套扎及硬化剂治疗的临床疗效观察

The clinical efficacy of elective endoscopic variceal ligation and endoscopic injection sclerotherapy for esophageal varices

目的:探讨食管静脉曲张择期采用静脉曲张套扎术(EVL)和硬化术(EIS)治疗后的临床疗效及预后。方法:对126例肝硬化合并食管静脉曲张择期行EVL及EIS二级预防患者进行回顾性研究,通过对比分析两组患者的一般资料以及治疗后随访情况对治疗效果进行总结。结果:术前两组患者一般资料无显著性差异,术后2周内套扎组有3例出现并发症,硬化组有9例出现并发症,6周内套扎组有2例出现再出血,硬化组有6例出现再出血,两组在6周内出现并发症及再出血率无显著性差异(P>0.05)。随访6个月结果显示静脉曲张复发率套扎组为66.67%(28/42)、硬化组为38.10%(32/84),随访至12个月结果显示静脉曲张复发率套扎组为83.33%(35/42)、硬化组为51.19%(43/84)。6个月后两组食管静脉曲张的复发率有显著性差异(P<0.05)。结论:EVL及EIS治疗食管胃底静脉曲张短期疗效较好,术后并发症和早期再出血率无显著差异,EIS治疗静脉曲张的再发生率明显低于EVL。

Objective:To evaluate the clinical efficacy and prognosis of endoscopic variceal ligation(EVL)and endoscopic injection sclerotherapy(EIS)on esophageal varices.Methods:It was a retrospective study of 126 patients with hepatic cirrhosis and esophageal varices undergoing EVL and EIS,respectively.The characteristics and prognosis of the EVL group and the EIS group were compared to evaluate two interventions.Results:There was no difference between the EVL group and the EIS group at baseline.In 2 weeks after the intervention,three participants reported complications in the EVL group,while nine in the EIS group.In 6 weeks after the intervention,two patients presented re-bleeding in the EVL group,whereas six in the EIS group,but there were no differences of complications and re-bleeding(P>0.05).A follow-up of 6 months presented a recurrence rate of 66.67%(28/42)in the EVL group,while it was 38.10%(32/84)in the EIS group(P<0.05).After a 12-month follow-up,the recurrence rate in the EVL group was 83.33%(35/42),while it was 51.19%(43/84)in the EIS group(P<0.05).Conclusion:EVL and EIS both presented acceptable results in the clinical administration on esophageal varices.There are no significant differences in complications and re-bleeding rate during the early phase.However,but the recurrence rate of varicose veins in EIS group is significantly lower than that in the EVL group.