评价内镜下钛夹联合组织胶治疗中重度胃底静脉曲张的临床价值

Evaluation on the Clinical Value of Endoscopic Titanium Clamp Combined with Tissue Glue in the Treatment of Moderate to Severe Gastric Varices

目的探讨内镜下钛夹+组织胶对中重度胃底静脉曲张治疗的临床价值。方法便利选择该院2018年1月—2019年1月收治的62例中重度胃底静脉曲张患者,通过计算机表法分组,分成试验组及参照组,每组31例。试验组选用内镜下钛夹+组织胶治疗,参照组选择组织胶单独治疗,比较两组临床效果的差异。结果随访1年,试验组和参照组再出血率、病死率分别为16.13%、9.68%,19.35%、16.13%,组间比较,差异无统计学意义(χ^(2)=0.110、0.571,P>0.05)。试验组和参照组组织胶使用量分别为(1.12±0.63)、(1.74±1.02)mL,差异有统计学意义(t=2.879,P<0.05)。试验组的再出血时间为(6.71±3.83)min,参照组再出血时间为(4.58±3.48)min,组间比较,差异有统计学意义(t=2.292,P<0.05)。治疗过程、随访期间,两组病例均未发生异位栓塞情况。结论中重度胃底静脉曲张患者接受内镜下钛夹+组织胶治疗,不但能有效控制患者组织胶使用量,而且利于降低患者再出血率及病死率、延长再出血时间,值得予以应用和推广。

Objective To explore the clinical value of endoscopic titanium clip+tissue glue in the treatment of moderate to severe gastric varices.Methods A total of 62 patients with moderate to severe gastric fundus varicose veins from January 2018 to January 2019 in the hospital were conveniently selected as the main group.They were divided into the test group and the reference group by computer table method.The two groups had 31 cases each.The test group was treated with endoscopic titanium clip+tissue glue,and the reference group was treated with tissue glue alone to compare the differences in clinical effects between the two groups.Results After 1 year of follow-up,the rebleeding rate and fatality rate of the test group and the reference group were 16.13%,9.68%,19.35%and 16.13%respectively.There was no statistical significance between the groups(χ^(2)=0.110,0.571,P>0.05).The amount of tissue glue used in the test group and the reference group was(1.12±0.63)mL and(1.74±1.02)mL respectively,the difference was statistically significant(t=2.879,P<0.05).The rebleeding time of the test group was(6.71±3.83)min,and the rebleeding time of the reference group was(4.58±3.48)min.The differences were statistical differences between the groups(t=2.292,P<0.05).During the course of treatment and follow-up,no ectopic embolism occurred in the two groups.Conclusion Patients with moderate to severe gastric varices receiving endoscopic titanium clip+tissue glue treatment can not only effectively control the amount of tissue glue used in the patient,but also help reduce the patient's rebleeding rate and mortality,and prolong the rebleeding time It is worthy of application and promotion.