内镜下组织胶“三明治”联合套扎术治疗2型胃底静脉曲张的研究

A Study on the endoscopic tissue glue sandwich combined with ligation in the treatment of type 2 gastric varicose veins

目的探讨内镜下组织胶“三明治”联合套扎术治疗2型胃底静脉曲张(GOV2)的临床疗效。方法选取2020年5月至2021年5月赣州市第五人民医院接诊的50例GOV2患者作为研究对象,根据治疗方法不同分为研究组与对照组,每组25例。研究组采用内镜下组织胶“三明治”联合套扎术,对照组采用内镜下组织胶+聚桂醇“三明治”夹心法。比较两组临床疗效、治疗前后门静脉血流动力学指标、术后并发症发生情况。结果两组治疗总有效率比较差异无统计学意义。治疗后,两组门静脉内径(PVD)、门静脉血流量(PBF)、胃左静脉(LGV)及脾静脉内径(SVD)均大于治疗前,门静脉血流速度(PVV)快于治疗前,门静脉压(PVP)低于治疗前,且研究组PVD、PBF、LGV及SVD均大于对照组,PVV快于对照组,PVP低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论内镜下组织胶“三明治”联合套扎术可有效改善GOV2患者血流动力学变化,减少术后并发症发生,值得临床推广应用。

Objective To explore the clinical efficacy of endoscopic tissue glue sandwich combined with ligation in the treatment of type 2 gastric varicose veins(GOV2).Methods 50 patients with GOV2 admitted to the Fifth People's Hospital of Ganzhou City from May 2020 to May 2021 were selected as the study subjects,they were divided into the study group and the control group according to different treatment methods,with 25 cases in each group.The study group used endoscopic tissue glue sandwich combined with ligation,while the control group used endoscopic tissue glue+poly(cinnamyl alcohol)sandwich sandwich method.The clinical efficacy,portal vein hemodynamic indexes before and after treatment,and postoperative complications were compared between the two groups.Results There was no statistically significant difference in the total effective rate between the two groups.After treatment,the portal vein diameter(PVD),portal vein blood flow(PBF),left gastric vein(LGV),and splenic vein(SVD)of the two groups were greater than before treatment,the portal vein blood flow velocity(PVV)was faster than before treatment,and the portal vein pressure(PVP)was lower than before treatment,and the PVD,PBF,LGV,and SVD in the study group were greater than those in the control group,PVV was faster than that in the control group,and PVP was lower than that in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The endoscopic tissue glue sandwich combined with ligation can effectively improve hemodynamic changes in patients with GOV2,reduce postoperative complications,and which is worthy of clinical promotion and application.