套扎或联合组织黏合剂治疗胃食管静脉曲张的疗效与门静脉血流的变化情况

Effect of band ligation or combined with tissue adhesive in the treatment of gastroesophageal varices and portal vein blood flow situational changes

前瞻性纳入42例胃食管静脉曲张患者资料,分组采用内镜下胶圈套扎或联合组织黏合剂治疗,结果显示套扎联合组织黏合剂治疗后胃左静脉内径、平均流速及血流量的下降趋势均比单纯胶圈套扎治疗明显,差异均有统计学意义(P值均<0.05);两组治疗后脾静脉和门静脉的内径、血流量和平均流速,以及肝脾大小、剪切波速度和肝功能分级均无明显变化(P值均>0.05);套扎联合组织黏合剂治疗食管静脉曲张、胃底静脉曲张的有效率(66.67%、52.38%)均高于单纯胶圈套扎(42.85%、23.81%)(P值均>0.05),后者再出血率更高(9.52%和19.05%,P>0.05)。提示联合治疗更为安全有效,且对肝功能和门静脉高压无明显影响。

42 cases with gastroesophageal varices were prospectively included.The groups were treated with endoscopic band ligation or combined with tissue adhesive.The results showed that the left gastric vein internal diameter,average blood flow velocity and blood flow volume after the treatment of band ligation combined with tissue adhesive were significantly lower than that of the treatment of band ligation alone,and the differences were statistically significant(P<0.05).Spleen and portal vein internal diameter,blood flow and average velocity,the liver and spleen size,shear wave velocity and liver function grade of the two groups after treatment did not change significantly(P>0.05).The effective rate of band ligation combined with tissue adhesive in the treatment of esophageal and gastric varices(66.67%,52.38%)were higher than that of band ligation alone(42.85%,23.81%)(P>0.05),and the re-bleeding rate of the latter was higher(9.52%and 19.05%,P>0.05).Hence,it is suggested that the combined therapy is safe and more effective,and has no apparent effect on liver function and portal hypertension.