逐级减压套扎法治疗胃底静脉曲张临床观察

Clinical observation of step-by-step decompression and ligation in treatment of gastric fundal varices

目的比较逐级减压套扎法与硬化剂治疗胃底静脉曲张的疗效差异,以期为临床提供参考。方法选择萍乡市第二人民医院消化内科2018年9月~2019年3月收治的胃底静脉曲张病例80例,随机分为两组,每组各40例,治疗组采取逐级减压套扎治疗。对照组采用传统硬化剂注射法治疗。治疗结束后比较两组患者治疗有效率、并发症发生情况、静脉曲张消除率及再出血率。结果(1)治疗后,治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。(2)两组间并发症发生率比较,差异均无统计学意义(均P>0.05)。(3)首次治疗后治疗组静脉曲张消除率高于对照组,两组差异具有统计学意义(P<0.05)。全部患者随访3个月,治疗组再出血率低于对照组,两组差异具有统计学意义(P<0.05)。结论逐级减压套扎法革新手术方式明显提高疗效,减少复发率,减轻患者负担,具有明显的实用性和先进性,值得在医疗机构推广,尤其是在基层医院,具有良好的社会效益和经济效益。

Objective To compare the efficacy of step-by-step decompression and ligation and sclerotherapy in the treatment of gastric fundal varices in order to provide reference for clinical practice.Methods Eighty patients with gastric fundal varices admitted to the Department of Gastroenterology,Pingxiang Second People's Hospital from September 2018 to March 2019 were randomly divided into two groups,with 40 patients in each group.The treatment group was treated with step-by-step decompression and ligation and the control group was treated with conventional sclerotherapy.After the treatment,the treatment effective rate,occurrence of complications,variceal elimination rate and rebleeding rate were compared between the two groups.Results(1)After the treatment,the total effective rate of the treatment group was higher than that of the control group,with statistically significant difference(P<0.05).(2)There was no statistically significant differences in the incidences of complications between the two groups(P>0.05 for all).(3)After the initial treatment,the variceal elimination rate of the treatment group was higher than that of the control group,with statistically significant difference between the two groups(P<0.05).All the patients were followed up for 3 months.The rebleeding rate of the treatment group was lower than that of the control group,with statistically significant difference between the two groups(P<0.05).Conclusion The step-by-step decompression and ligation method has revolutionized the surgical method,significantly improved the curative effect,reduced the recurrence rate and reduced the burden on patients.It has obvious practicability and advancement and good social and economic benefits,which is worthy of promotion in medical institutions,especially in primary hospitals.