内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张的疗效观察

目的:探讨内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张的疗效。方法:选择我院于2014年2月~2015年12月间收治的肝硬化食管胃底静脉曲张患者共88例,经随机数字表法将患者分为观察组及对照组各44例。给予观察组内镜下注射聚桂醇与组织胶治疗,给予对照组内镜下注射碘化油与组织胶治疗。统计两组患者手术中组织胶总用量,注射点数及平均每点组织胶用量。治疗14d后行胃镜检查,评价两组患者疗效,统计两组患者再出血、再出血死亡情况与不良反应情况。结果:观察组组织胶总用量、平均每点组织胶用量均低于对照组,差异均有统计学意义(P0.05);治疗6个月后观察组疗效总有效率高于对照组,差异均有统计学意义(P0.05)。两组注射点数、再出血发生率、再出血死亡率及并发症发生率比较无统计学差异(P0.05)。结论:经内镜下注射聚桂醇与组织胶治疗肝硬化食管胃底静脉曲张安全有效,治疗费用低,值得推广。

Esophageal and Gastric Varices in Patients with Liver Cirrhosis: Curative Effect of Endoscopic Injection of Polidocanol and Tissue Adhesive

ABSTRACT Objective: To investigate the effect of endoscopic injection of Polidocanol and tissue adhesive on esophageal and gastric varices in patients with liver cirrhosis. Methods: A total of 88 patients with liver cirrhosis accompanied by esophageal and gastric varices, who were admitted to Affiliated Drum Tower Hospital of Medical College of Nanjing University from February 2014 to December 2015, were selected and randomly divided into observation group(n-44) and control group(n-44). The observation group was treated with endoscopic injection of Polidocanol and tissue adhesive, while the control group was treated with endoscopic injection of lipiodol and tissue adhesive. The total amount of tissue adhesive, the number of injection points and the average amount of tissue adhesive in the two groups were recorded. After 14 days of treatment, gastroscopy was performed. The efficacy of the two groups of patients was evaluated.The numbers of rebleeding, rebleeding mortality and adverse reactions in the two groups were analyzed. Results: The total amount of tissue adhesive and the average amount of tissue glue in the observation group were lower than those in the control group, the differences were statistically significant(P<0.05). The total effective rate of the observation group was higher than that of the control group 6 months after treatment, the difference was statistically significant(P<0.05). There were no significant differences in the number of injection points, rebleeding rate, rebleeding mortality and adverse reactions rate between the two groups(P>0.05). Conclusion: Using endoscopic injection of Polidocanol and tissue adhesive to treat the patients with liver cirrhosis accompanied by esophageal and gastric varices has good safety, good curative effect and low treatment costs, which is worthy of clinical promotion.