内镜下硬化剂联合组织胶注射治疗门静脉高压合并食管胃静脉曲张的疗效及排胶再出血率观察

Efficacy of Endoscopic Sclerotherapy Combined with Tissue Glue Injection in the Treatment of Portal Hypertension Complicated with Esophageal and Gastric Varices and Observation of Rebleeding Rate

目的观察内镜下硬化剂联合组织胶注射治疗门静脉高压(PHT)合并食管胃静脉曲张(GOV)的临床疗效及排胶再出血率。方法选取2017年1月-2020年12月井冈山大学附属医院消化内科收治的72例PHT合并GOV患者,依据随机数字表法分为对照组与观察组,各36例。对照组行内镜下组织胶注射治疗,观察组则采用内镜下硬化剂联合组织胶注射治疗,比较两组止血成功率、再出血率、静脉曲张缓解效果、组织胶用量、治疗次数、静脉曲张消失时间以及并发症情况。结果两组止血成功率比较,差异无统计学意义(P>0.05);观察组再出血率低于对照组,静脉曲张缓解有效率高于对照组(P<0.05);观察组组织胶用量及治疗次数少于对照组(P<0.05),且静脉曲张消失时间短于对照组(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05),但观察组溃疡发生率高于对照组(P<0.05)。结论内镜下硬化剂联合组织胶注射治疗PHT合并GOV止血效果确切,可降低其再出血率,增强静脉曲张的治疗效果,减少组织胶用量与注射次数,缩短治疗时间,且不增加术后并发症风险,但伴有较高的溃疡发生率。

Objective To observe the clinical efficacy of endoscopic sclerotherapy combined with tissue glue injection in the treatment of portal hypertension(PHT)complicated with esophageal and gastric varices(GOV)and the rate of rebleeding after glue drainage.Methods A total of 72 patients with PHT complicated with GOV admitted to Department of Gastroenterology,Affiliated Hospital of Jinggangshan University from January 2017 to December 2020 were selected and divided into control group and observation group according to random number table method,with 36 cases in each group.The control group was treated with endoscopic tissue glue injection,and the observation group was treated with endoscopic sclerotherapy combined with tissue glue injection.The success rate of hemostasis,rebleeding rate,varicose vein remission effect,tissue glue dosage,treatment times,varicose vein disappearance time and complications were compared between the two groups.Results There was no significant difference in the success rate of hemostasis between the two groups(P>0.05).The rebleeding rate in the observation group was lower than that in the control group,and the effective rate of varicose vein relief was higher than that in the control group(P<0.05).The amount of tissue glue and treatment times in the observation group were less than those in the control group(P<0.05),and the disappearance time of varicose veins was shorter than that in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05),but the incidence of ulcer in the observation group was higher than that in the control group(P<0.05).Conclusion Endoscopic sclerotherapy combined with tissue gel injection in the treatment of PHT combined with GOV has a definite hemostatic effect,which can reduce the rebleeding rate,enhance the therapeutic effect of varicose veins,reduce the dosage and injection times of tissue gel,shorten the treatment time,and do not increase the risk of postoperative complications,but it has a high incidence of ulcer.