密集套扎、套扎序贯组织胶治疗和组织胶注射治疗胃底静脉曲张效果对比研究

Effect Comparative Study of Dense Ligation,Sequential Ligation with Tissue Glue Therapy,and Tissue Glue Injection in Treatment of Gastric Fundal Varices

目的 研究密集套扎、套扎序贯组织胶治疗和组织胶注射治疗胃底静脉曲张的临床效果。方法 选取2020年12月-2022年4月本院收治的42例胃底静脉曲张患者作为研究对象,按治疗方式的不同将其分为三组:组织胶组(13例,实施组织胶注射治疗)、序贯套扎组(14例,实施套扎序贯组织胶治疗)和密集套扎组(15例,实施密集套扎治疗)。统计分析三组治疗前后的胃底静脉曲张内镜特征变化(直径、静脉曲张数目)、门静脉血流动力学指标[门静脉内径(PVD)、门静脉压(PVP)、门静脉血流量(PVF)和门静脉血流速度(PVV)];并比较三组的疗效、并发症发生率、早期再出血率、迟发性再出血率、疾病复发率。结果 治疗后,三组的胃底静脉曲张直径、静脉曲张数目均小于治疗前,而密集套扎组的指标更优(P<0.05);三组的PVP、PVF、均低于治疗前,而密集套扎组的指标更低(P<0.05);三组的治疗总有效率相比差异无统计学意义(P>0.05);密集套扎组的早期再出血率、迟发性再出血率、疾病复发率明显低于组织胶组、序贯套扎组(P<0.05);密集套扎组的并发症发生率低于组织胶组、序贯套扎组,结果相比差异无统计学意义(P>0.05)。结论 密集套扎、套扎序贯组织胶、组织胶注射治疗胃底静脉曲张的疗效相当,但密集套扎的并发症发生率更低,能有效改善患者门静脉血流动力学,减少再出血率和复发率,应用价值理想。

Objective To study clinical effect of dense ligation,sequential tissue glue therapy,and tissue glue injection in treatment of gastric fundal varices.Methods The paper chose chose 42 patients with gastric fundal varices admitted to our hospital from December 2020 to April 2022 as study subjects,and divided them into three groups according to different treatment methods:tissue glue group(13 cases,treated with tissue glue injection),sequential ligation group(14 cases,with tissue glue),and dense ligation group(15 cases,with dense ligation).Changes in endoscopic characteristics(diameter,number of varices)and portal vein hemodynamic indicators(portal vein diameter(PVD),portal vein pressure(PVP),portal vein blood flow(PVF),and portal vein blood flow velocity(PVV))of gastric varices were statistically analyzed before and after treatment among three groups,curaitve effect,incidence of complications,early rebleeding rate,delayed rebleeding rate,and disease recurrence rate were compared among three groups.Results After treatment,diameter and number of gastric varices among three groups were less than before treatment,indicators in dense ligation group were better(P<0.05).PVP and PVF of three groups were lower than before treatment,indicators of dense ligation group were lower(P<0.05).There was no statistically significant difference in total effective rate of treatment among three groups(P>0.05).Early rebleeding rate,delayed rebleeding rate,and disease recurrence rate of dense ligation group were significantly lower than tissue glue group and sequential ligation group(P<0.05).Incidence of complications in dense ligation group was lower than tissue glue group and sequential ligation group,difference was not statistically significant(P>0.05).Conclusion Dense ligation,sequential tissue glue injection,and tissue glue injection can achieve similar effect for gastric fundal varices,incidence of complications in dense ligation was less,can improve portal vein hemodynamics effectively,reduce rebleeding and recurrence rate of patients,which has ideal application value.