内镜下加空气改良组织黏合剂三明治夹心注射法治疗肝硬化胃底静脉曲张30例疗效观察

Efficacy of modified sandwich method with air under endoscope in the treatment of gastric varicose veins:an observation of 30 cases

目的观察内镜下加空气改良组织黏合剂三明治夹心注射法治疗肝硬化胃底静脉曲张的疗效。方法选取2018年1-5月阜阳市第二人民医院肝硬化胃底静脉曲张病人60例,采用随机数字表法分为观察组和对照组,每组30例。对照组内镜下采用聚桂醇+组织黏合剂+2 mL 0.9%氯化钠溶液三明治夹心注射法治疗,观察组内镜下采用聚桂醇+组织黏合剂+空气+12 mL 0.9%氯化钠溶液注射治疗;比较两组首支组织黏合剂堵针数,组织黏合剂、注射针使用量,堵针率及治疗1、3个月后再出血情况。结果观察组使用组织黏合剂93支,使用注射针53根,首支组织黏合剂堵针0根,堵针率为0;对照组使用组织黏合剂103支,使用注射针92根,首支组织黏合剂堵针11根,堵针率约10.7%,对照组堵针率明显高于观察组,差异有统计学意义(P<0.01)。两组治疗1、3个月后再出血比较,差异无统计学意义(P>0.05)。结论内镜下组织黏合剂治疗增加空气注射、0.9%氯化钠冲洗和熟练操作控制总时间,可减少堵针,减少组织黏合剂和注射针的浪费;同时减少拔针出血,降低治疗费用。

Objective To observe the efficacy of gastroscopy plus air modified tissue sandwich injection in the treatment of gastric varicose veins.Methods Sixty patients of gastric varicose veins,treated in The Second People’s Hospital of Fuyang from January2018 to May 2018 were randomly assigned into study group[n=30,lauromacrogol+ tissue glue + air + saline(12 m L)]and control group[n=30,lauromacrogol+ tissue glue + saline(2 mL)].A comparison was made between the two groups of the blocking number of the first tissue glue,the number of tissue glue and injector used,the blocking rate and rebleeding at 1 month and 3 months of treatment.Results In the study group,93 tissue glues were injected,53 injectors were used,and no blocking(0%)was found during the use of the first tissue glue,while in the control group,103 tissue glues were injected,92 injectors were used,and11(10.7%)times of blocking was found during the use of the first tissue glue.The needle blocking rate in the control group was significantly higher than that in the study group(P<0.01).There was no significant difference in the rebleeding rate between the control group and the study group at one month and three months of treatment.Conclusion By increasing air injection,flushing with saline and controlling the total injection time,the needle blocking and the waste of tissue glues and injectors can be reduced.Simultaneously,the bleeding caused by needle extraction can be reduced and the treatment cost can be decreased.