胃镜下钛夹联合组织胶、聚桂醇注射治疗肝硬化胃底静脉曲张的临床效果

Clinical effect of titanium clip combined with tissue glue and polylauryl alcohol injection under gastroscope in the treatment of cirrhotic gastric varices

目的探讨胃镜下钛夹联合组织胶、聚桂醇注射治疗肝硬化胃底静脉曲张的临床效果。方法选取商南县医院2017年1月至2019年8月拟采取手术治疗的114例肝硬化胃底静脉曲张患者作为研究对象,采用随机数字表法将其分为研究组和对照组,各57例。研究组采用胃镜下钛夹联合组织胶+聚桂醇注射(1.0 mL组织胶+5.0 mL聚桂醇+2.5 mL空气+3.0 mL氯化钠)治疗,对照组采用组织胶+聚桂醇注射(1.0 mL组织胶+2.0 mL聚桂醇+2.5 mL空气+3.0 mL的氯化钠)治疗。比较两组的肝功能指标、血红蛋白(Hb)及凝血功能指标、门静脉血流参数及治疗效果。结果治疗后,两组的ALB、Hb、PLT、PTA较治疗前均升高,TBIL、ALT、PT、APTT较治疗前均降低(P<0.05)。治疗后,研究组的APTT低于对照组,PTA高于对照组(P<0.05);治疗后,研究组的门静脉血流速度、门静脉血流量均高于对照组(P<0.05)。治疗后,研究组的显效率为73.68%,有效率为26.32%,无效率为0.00%,对照组的显效率为56.14%,有效率为42.11%,无效率为1.75%,研究组的治疗效果优于对照组,差异具有统计学意义(P<0.05)。结论胃镜下钛夹联合组织胶+聚桂醇注射治疗较组织胶+聚桂醇治疗肝硬化胃底静脉曲张具有更好的临床效果。

Objective To investigate the clinical effect of titanium clip combined with tissue glue and polylauryl alcohol injection under gastroscope in the treatment of cirrhotic gastric varices.Methods A total of 114 patients with cirrhosis and gastric fundus varices planned to be treated surgically in Shangnan county hospital from January 2017 to August 2019 were selected as the research objects.The patients were randomly divided into study group and control group,with 57 cases in each group.The study group was treated with titanium clip combined with tissue glue+lauryl alcohol injection(1.0 mL tissue glue+5.0 mL lauryl alcohol+2.5 mL air+3.0 mL sodium chloride)under gastroscope,and the control group was treated with tissue glue+lauryl alcohol injection(1.0 mL tissue glue+2.0 mL lauryl alcohol+2.5 mL air+3.0 mL sodium chloride).The indexes of liver function,hemoglobin(HB)and coagulation function portal vein blood flow parameters and therapeutic effect were compared between the two groups.Results After treatment,ALB,Hb,PLT and PTA in the two groups were higher than those before treatment,and TBIL,ALT,PT and APTT were lower than those before treatment(P<0.05).After treatment,APTT in the study group was lower than that in the control group and PTA was higher than that in the control group(P<0.05).After treatment,the portal vein blood flow velocity and portal vein blood flow in the study group were higher than those in the control group(P<0.05).After treatment,the effective rate of the study group was 73.68%,the effective rate was 26.32%,the ineffective rate was 0.00%,and the effective rate of the control group was 56.14%,the effective rate was 42.11%,and the ineffective rate was 1.75%,the therapeutic effect of the study group was better than that of the control group,there was significant difference between the two groups(P<0.05).Conclusion Gastroscopic titanium clip combined with tissue glue+polylauryl alcohol injection has better clinical effect than tissue glue+polylauryl alcohol in the treatment of cirrhotic gastric varices.