本文選題：肝硬化　切入點(diǎn)：食管靜脈曲張　出處：《首都醫(yī)科大學(xué)學(xué)報(bào)》2016年05期 　論文類型：期刊論文

【摘要】：目的比較內(nèi)鏡下不同序貫治療方法對(duì)肝硬化合并食管靜脈曲張破裂出血(esophageal varices bleeding,EVB)二級(jí)預(yù)防的療效。方法收集資料完整且明確診斷為肝硬化合并EVB(內(nèi)鏡下分級(jí)均為重度)且行內(nèi)鏡下治療的62例患者,分為3組:套扎序貫套扎組22例,硬化劑序貫硬化劑組10例,套扎序貫硬化劑組30例。以上病例隨訪1年以上,若1年內(nèi)出現(xiàn)大出血、死亡為終點(diǎn)并進(jìn)行回顧性分析。詳細(xì)記錄所有病例相關(guān)合并癥、5天治療失敗率、6周病死率、1年再出血率、平均住院時(shí)間以及費(fèi)用等。結(jié)果 1)3組患者合并癥例數(shù)比較,硬化劑序貫硬化劑組中食管狹窄及感染相對(duì)其他兩組高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2)5天治療失敗率、6周病死率在3種序貫方式比較中差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),但在1年再出血率中,套扎序貫硬化劑組效果佳,未出現(xiàn)再出血情況。其他兩組(套扎序貫套扎組、硬化劑序貫硬化劑組)再出血較高。3)3組不同序貫療法間住院天數(shù)差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。套扎序貫套扎組與硬化劑序貫硬化劑組的術(shù)中費(fèi)用差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3組比較,套扎序貫硬化劑組住院時(shí)間相對(duì)較短,費(fèi)用較低。結(jié)論內(nèi)鏡下序貫治療是治療EVB的重要方法,套扎序貫硬化劑模式的5天治療失敗率和6周病死率,與另外兩種序貫治療模式相當(dāng),但1年再出血率低、醫(yī)療資源節(jié)約上具有更大的優(yōu)勢(shì)。
[Abstract]:Objective to compare the efficacy of different sequential endoscopic therapy in the secondary prevention of cirrhosis with esophageal variceal hemorrhage. Methods the data were collected and the diagnosis of cirrhosis with EVB was confirmed. Of 62 patients who received endoscopic treatment, The patients were divided into 3 groups: 22 cases in the sequential ligation group, 10 cases in the sclerosing agent group and 30 cases in the ligation sequential sclerosing agent group. Death was the end point and retrospective analysis was carried out. The failure rate of treatment for 5 days and the mortality rate of 6 weeks, rebleeding rate of 1 year, average hospitalization time and cost were recorded in detail. Results 1 the number of patients with complications was compared among the 3 groups. In the Sequential sclerosing agent group, the esophageal stenosis and infection were higher than those in the other two groups, and the difference was statistically significant (P 0.05). There was no significant difference in the 6-week mortality rate between the three sequential sclerosing agents, but there was no significant difference in the 1-year rebleeding rate. The effect of sequential sclerosing agent group was good, and no further bleeding occurred. The other two groups (ligation sequential ligation group, Sequential ligation group, There were significant differences in hospitalization days among different sequential therapy groups (P 0.05), and there was significant difference in intraoperative cost between sequential ligation group and sclerosing agent group (P 0.05). Conclusion Sequential endoscopic therapy is an important method for the treatment of EVB. It is similar to the other two sequential treatment modes, but the rate of rebleeding in one year is low, and the saving of medical resources has more advantages.
【作者單位】： 武漢大學(xué)人民醫(yī)院消化內(nèi)科消化內(nèi)鏡中心湖北省消化疾病微創(chuàng)診治醫(yī)學(xué)臨床研究中心;
【基金】：湖北省衛(wèi)生和計(jì)劃生育委員會(huì)西醫(yī)類一般項(xiàng)目(WJ2015MB091)~~
【分類號(hào)】：R575.2

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