EVL+EVS序贯疗法治疗肝硬化食管胃底静脉曲张破裂出血的临床研究

Clinical Study on EVL+EVS Sequential Therapy for Esophageal Gastric Variceal Bleeding in Cirrhosis

目的:探讨内镜下套扎术(endoscopic variceal ligation,EVL)+内镜下硬化剂注射术(endoscopic varices sclerotherapy,EVS)序贯疗法治疗肝硬化食管胃底静脉曲张破裂出血后临床变化及并发症发生情况。方法:以2020年4月-2021年12月江阴市人民医院消化内科收治的138例肝硬化食管胃底静脉曲张破裂出血患者为研究对象,以随机数字表法分为治疗组与对照组,各69例。其中对照组予以EVL治疗,治疗组予以EVL+EVS序贯疗法。对比两组的临床效果及并发症发生情况。结果:治疗组的再次治疗次数少于对照组,差异有统计学意义(P<0.05)。两组的曲张静脉情况比较,差异无统计学意义(P>0.05)。治疗组治疗后的白细胞、血小板计数高于对照组(P<0.05)。治疗组的并发症发生率为4.35%,低于对照组的15.94%(P<0.05)。结论:EVL+EVS序贯疗法治疗有助于减少肝硬化食管胃底静脉曲张破裂出血患者再次治疗次数,降低并发症的发生率,在临床上值得推广。

Objective:To investigate the clinical changes and complications of endoscopic gastric variceal ligation(EVL)+endoscopic variceal sclerotherapy(EVS)sequential therapy for esophageal variceal bleeding due to cirrhosis.Method:A total of 138 patients with esophageal gastric varices bleeding due to cirrhosis who were treated in the Department of Gastroenterology of Jiangyin People’s Hospital from April 2020 to December 2021 were taken as the research object.They were randomly divided into the treatment group and the control group,with 69 cases in each group.The control group was treated with EVL,and the treatment group was treated with EVL+EVS sequential therapy.The clinical effects and complications of the two groups were compared.Result:The number of retreatments in the treatment group was less than that in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in varicose veins between the two groups(P>0.05).After treatment,the white blood cell count and platelet count in the treatment group were higher than those in the control group(P<0.05).The incidence of complications in the treatment group was 4.35%,which was lower than 15.94%in the control group(P<0.05).Conclusion:EVL+EVS sequential therapy is helpful to reduce the number of retreatments for patients with esophageal gastric varices bleeding due to cirrhosis,and reduce the incidence of complications.It is worth promoting in clinical practice.