内镜下注射聚桂醇在肝硬化食管胃底静脉曲张治疗中的应用价值

Application value of endoscopic injection of lauromacrogol for treatment of esophageal and gastric varices with cirrhosis

目的探讨内镜下注射聚桂醇在肝硬化食管胃底静脉曲张中的应用价值。方法选取我院2015年1月至2017年1月收治的108例肝硬化食管胃底静脉曲张患者为研究对象,根据随机数字表法将其分成对照组与观察组,各54例。两组均给予常规对症处理,对照组采用内镜下注射传统组织胶治疗,观察组采用内镜下注射聚桂醇治疗。比较两组治疗效果、排胶率、再出血率以及并发症发生率。结果观察组治疗总有效率为88.89%,高于对照组的72.22%,差异有统计学意义(P<0.05)。术后1、2周及1、2、3、6、9、12、15、18个月,两组的排胶率比较,差异无统计学意义(P>0.05)。观察组术后再出血总发生率为12.96%,低于对照组的29.63%,差异有统计学意义(P<0.05)。观察组无患者发生异位栓塞,对照组异位栓塞发生率为11.11%,组间比较,差异有统计学意义(P<0.05)。结论与传统组织胶相比,内镜下注射聚桂醇能提高临床疗效,降低术后再出血、异位栓塞发生率,对排胶率无明显影响。

Objective To investigate the application value of endoscopic injection of lauromacrogol for treatment of esophageal and gastric varices with cirrhosis. Methods A total of 108 cases of esophageal and gastric varices with cirrhosis admitted in our hospital from January 2015 to January 2017 were selected as the study objects and divided into control group and observation group according to random number table method, with 54 cases in each group. The two groups were given conventional symptomatic treatment. The control group was treated by endoscopic injection of traditional tissue adhesive, while the observation group was treated by endoscopic injection of lauromacrogol. The therapeutic effects, gum removal rates, rebleeding rates and the incidences of complications were compared between the two groups. Results The total effective rate of treatment in the observation group was 88.89%, which was higher than 72.22% in the control group,and the difference was statistically significant(P <0.05). There were no significant differences in the gum removal rates between the two groups at 1, 2 weeks and 1, 2, 3, 6, 9, 12, 15, 18 months after operation(P>0.05). The total incidence of postoperative rebleeding in the observation group was 12.96%, which was lower than 29.63% in the control group, and the difference was statistically significant(P<0.05). There was no ectopic embolism in the observation group and 11.11% in the control group, and the difference between the two groups was statistically significant(P<0.05). Conclusion Compared with traditional tissue adhesive, endoscopic injection of lauromacrogol can improve the clinical efficacy and reduce the incidences of postoperative rebleeding and ectopic embolism, without significant effect on the gum removal rate.