内镜下高渗葡萄糖联合组织胶注射与聚桂醇联合组织胶对胃底静脉曲张出血的疗效分析

Efficacy of Endoscopic Hyperosmolar Glucose Combined with Tissue Adhesive Injection and Lauromacrogol Combined with Tissue Adhesive Injection in the Treatment of Gastric Varices Bleeding

目的:探讨组织胶联合聚桂醇治疗胃底静脉曲张出血(GVB)的临床效果。方法:选取2017年1月-2020年1月本院40例GVB内镜下治疗患者,根据随机数字表法,分为治疗组和对症组,每组20例。治疗组采用聚桂醇联合组织胶注射治疗,对症组采用高渗葡萄糖联合组织胶注射治疗。比较两组总有效率、止血情况、再出血情况、不良反应发生情况。结果:两组止血成功率均为100%。治疗组总有效率为85.00%,高于对症组的55.00%,差异有统计学意义(P<0.05)。治疗组术后再出血率为10.00%,低于对症组的20.00%,差异无统计学意义(χ^(2)=0.784,P=0.240)。治疗组再出血时间为(2.70±1.22)个月,短于对症组的(5.62±2.45)个月,差异有统计学意义(t=4.771,P<0.05)。两组均未发生异位栓塞。两组发热、排胶出血、局部黏膜坏死发生率比较,差异均无统计学意义(P>0.05)。结论:组织胶联合聚桂醇治疗胃底静脉曲张的效果优于高渗葡萄糖联合组织胶注射治疗,且不增加术后再出血发生率。

Objective:To assess the efficacy of tissue adhesive combined with lauromacrogol in the treatment of gastric varices bleeding(GVB).Method:A total of 40 GVB endoscopic patients in our hospital from January 2017 to January 2020 were selected,and they were divided into treatment group and symptomatic group according to random number table method,20 cases in each group.The treatment group was treated with tissue adhesive injection combined with Lauromacrogol,and the symptomatic group was treated with Hypertonic Glucose and tissue adhesive injection.The total effective rate,hemostasis situation and the incidence of adverse reactions,rebleeding were compared between two groups.Result:The hemostatic success rate of both groups were 100%.The total effective rate of treatment group was 85.00%,it was higher than 55.00%of symptomatic group,the difference was statistically significant(P<0.05).The rate of postoperative rebleeding of treatment group was 10.00%,it was lower than 20.00%of symptomatic group,the difference was not statistically significant(χ^(2)=0.784,P=0.240).The period of rebleeding of symptomatic group was(2.70±1.22)months,it was shorter than(5.62±2.45)months of symptomatic group,and the difference was significant difference(t=4.771,P<0.05).No ectopic embolism occurred of both groups.There were no significant differences in the incidence of fever,row of glue bleeding and local mucosal necrosis between two groups(P>0.05).Conclusion:The improved efficacy of tissue adhesive combined with lauromacrogol in the treatment of GVB is better than that of hypertonic glucose combined with tissue adhesive injection,and does not increase the incidence of postoperative rebleeding.