内镜下1型食管胃静脉曲张组织胶注射术与套扎术临床疗效的回顾性分析

Retrospective Analysis on Clinical Curative Effects of Endoscopic Type 1 Gastroesophageal Varices Tissue Adhesive Injection and Ligation

目的对比胃镜下静脉套扎术(EVL)和胃镜下组织胶注射术(EIS)治疗1型食管胃静脉曲张的临床效果。方法选取2017年6月至2019年6月就诊于郑州大学第一附属医院的72例1型胃底静脉曲张患者,根据手术方式分为A组(组织胶注射,42例)和B组(套扎治疗,30例),比较两组之间的临床效果、并发症及住院成本。结果 A组和B组的手术成功率分别为97.6%(41/42)和93.3%(28/30),差异无统计学意义(P>0.05)。A组和B组的总体再出血率分别为7.1%(3/42)和13.3%(4/30),差异无统计学意义(P>0.05)。A组和B组的总体有效率分别为88.1%(37/42)和93.3%(28/30),差异无统计学意义(P>0.05)。A组和B组的总不良反应率分别为21.4%和16.7%,差异无统计学意义(P>0.05)。B组的成本效益比(C/E)显著高于A组,差异有统计学意义(P<0.05)。结论与组织胶注射术相比,内镜下1型食管胃静脉曲张套扎术在不降低总体有效率、不增加副作用的情况下可明显减轻患者的医疗负担。

Objective To compare clinical curative effects of endoscopic type 1 gastroesophageal varices tissue adhesive injection and ligation.Methods A total of 72 patients with type 1 gastroesophageal varices who underwent endoscopic tissue adhesive injection and ligation treatment from June 2017 to June 2019 in the First Affiliated Hospital of Zhengzhou University were selected in the study. The patients were divided into group A(tissue adhesive injection, 42 patients) and group B(ligation, 30 patients) according to therapeutic methods. The therapeutic effects、complication and hospital cost of two groups were observed.Results The success ratio of operation in group A and group B were 97.6%(41/42) and 93.3%(28/30) separately, there was no statistically difference(P>0.05). The total rebleeding rate in group A and group B were 7.1%(3/42) and 13.3%(4/30) separately, there was no statistically difference(P>0.05). The total effective rate in group A and group B were 88.1%(37/42) and 93.3%(28/30) separately, there was no statistically difference(P>0.05). The total rate of adverse reactions in group A and group B were 21.4% and 16.7% separately, there was no statistically difference(P>0.05). The group B C/E was lower than that of the group A, there was statistically difference(P<0.05).Conclusion Compared with tissue adhesive injection, endoscopic type 1 gastroesophageal varices ligation can reduce the medical burden of patients without reducing the total effective rate and increasing total rate of adverse reactions.