本文選題：肝硬化　切入點：靜脈曲張　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的分析肝硬化食管靜脈曲張(esophageal varices,EV)首次出血后,規(guī)范化行內(nèi)鏡下食管靜脈曲張?zhí)自?endoscopic variceal ligation,EVL)或聯(lián)合胃靜脈曲張組織膠注射術(shù)的臨床效果。方法收集2012年2月至2014年6月期間,因肝硬化EV出血首次于重慶醫(yī)科大學(xué)附屬第一醫(yī)院內(nèi)鏡室行內(nèi)鏡治療成功的97例患者的臨床資料,按后續(xù)是否規(guī)律內(nèi)鏡隨訪分為兩組,對照組48例僅接受保守治療,治療組49例規(guī)律行內(nèi)鏡治療,記錄并分析兩組治療方案、曲張靜脈變化及并發(fā)癥、預(yù)后的差異。結(jié)果治療組共49例患者,年齡位于25-72(50.31±9.97)歲;男30例,女19例,男女比例1.6:1。合并食管胃靜脈曲張(Gastroesophageal varices,GOV)GOV1型22例,GOV2型12例,GOV3型4例。該組患者經(jīng)過連續(xù)2-3次內(nèi)鏡治療后EV緩解率100%,GV消除率93.75%。隨訪發(fā)現(xiàn)EV復(fù)發(fā)、再出血、死亡率1個月內(nèi)分別為2.04%、0、0,12個月內(nèi)分別為16.33%、4.08%、0,20個月內(nèi)分別為20.40%、14.29%、4.08%,期間無胃靜脈曲張出血(gastric varices bleeding,GVB)發(fā)生。對照組共48例患者,年齡位于26-74(51.56±10.32)歲。男31例,女17例,男女比例1.8:1。合并GOV1型21例,GOV2型10例,GOV3型7例。該組患者首次內(nèi)鏡治療成功后未規(guī)律后續(xù)內(nèi)鏡隨訪,隨訪發(fā)現(xiàn)EV復(fù)發(fā)、再出血、死亡率1個月內(nèi)分別為:4.17%、2.08%、2.08%,12個月內(nèi)分別為41.67%、33.33%、8.33%,20個月內(nèi)分別為72.92%、56.25%、20.83%,期間9例發(fā)生胃靜脈曲張出血(18.75%)。結(jié)論肝硬化EV首次出血后再出血率高,規(guī)律胃鏡隨訪、連續(xù)內(nèi)鏡下套扎2-3次,可明顯緩解EV程度、預(yù)防再出血;對合并GV的患者及時行內(nèi)鏡下組織膠注射術(shù),可有效消除GV、預(yù)防GVB。
[Abstract]:Objective to analyze the cirrhosis esophageal varices (esophageal varices, EV) after the first hemorrhage, standardized endoscopic esophageal variceal ligation (endoscopic variceal, ligation, EVL) clinical effect of gastric varices or combined with tissue glue injection operation. Methods from February 2012 to June 2014, the clinical data of 97 cases of hemorrhage of cirrhosis EV for the first time in First Affiliated Hospital of Chongqing Medical University Department of endoscopy endoscopic treatment were successful, according to the following rules if endoscopy were divided into two groups, 48 cases in the control group only received conservative treatment, 49 cases of endoscopic treatment group, treatment group two and record analysis, varicose vein changes and complications, prognosis is different. A total of 49 patients in the treatment group in 25-72, the age (50.31 + 9.97) years old; male 30 cases, female 19 cases, male to female ratio 1.6:1. of esophageal and gastric varices (Gastroesophageal, varices, GOV) GOV1 22 渚，

本文編號：1662649