辅助金属夹应用于内镜下组织胶注射治疗2型食管胃静脉曲张患者中的临床疗效及安全性

The clinical efficacy and safety of the auxiliary metal clip in the treatment of type 2 gastroesophageal varices by endoscopic tissue glue injection

目的探讨辅助金属夹应用于内镜下组织胶注射治疗2型食管胃静脉曲张(GOV2)患者中的临床疗效及安全性。方法选取2018年4月至2020年4月该院收治的86例GOV2患者作为研究对象,按随机数字表法将患者分为对照组、观察组,各43例。对照组单纯采用内镜下组织胶注射治疗,观察组在对照组基础上应用金属夹辅助夹闭血管。观察两组患者疗效、治疗前后胃底曲张静脉直径及并发症发生情况。两组患者随访6个月,记录随访结果。结果观察组治疗总有效率为97.67%,高于对照组的81.40%,差异有统计学意义(P<0.05)。治疗前两组患者胃底曲张静脉直径比较,差异无统计学意义(P>0.05);治疗后观察组胃底曲张静脉直径明显小于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为6.98%,低于对照组的13.95%,差异有统计学意义(P<0.05)。观察组再出血和死亡的发生率均低于对照组,差异有统计学意义(P<0.05)。结论在内镜下组织胶注射治疗GOV2时使用辅助金属夹的效果较好,能明显减小胃底曲张静脉的直径,降低并发症、再出血及死亡的发生率,值得临床应用及推广。

Objective To explore the clinical efficacy and safety of the auxiliary metal clip in the treatment of type 2 gastroesophageal varices(GOV2) by endoscopic tissue glue injection.Methods A total of 86 GOV2 patients admitted to the hospital from April 2018 to April 2020 were selected as the research objects, and the patients were divided into the control group and the observation group according to a random number table method, with 43 cases in each group.The control group was only treated with tissue glue injection under endoscopy.On the basis of the control group, the observation group was treated with metal clips to assist in vascular closure.The curative effect, diameter of varicose vein of fundus of stomach and complications were observed before and after treatment.The two groups were followed up for 6 months to record the follow-up results.Results The total effective rate of treatment in observation group was 97.67%,which was higher than 81.40% in control group, and the difference was statistically significant(P<0.05).Before treatment, there was no significant difference in the diameter of varicose vein of fundus of stomach between the two groups(P>0.05).After treatment, the diameter of varicose vein of fundus of stomach in observation group was significantly smaller than that in control group, and the difference was statistically significant(P<0.05).The complication rate in observation group was 6.98%,which was lower than 13.95% in control group, and the difference was statistically significant(P<0.05).The incidence of rebleeding and death in observation group were lower than those in control group, and the differences were statistically significant(P<0.05).Conclusion The effect of using auxiliary metal clip in endoscopic tissue glue injection in the treatment of GOV2 is better.It could significantly reduce the diameter of varicose vein of fundus of stomach, reduce the incidence of complications, rebleeding and death, and is worthy of clinical application and promotion.