本文選題：食管胃底靜脈曲張　切入點(diǎn)：改良三明治法　出處：《中國內(nèi)鏡雜志》2017年02期

【摘要】：目的探討改良三明治法同步與序貫聯(lián)合套扎治療食管胃底靜脈曲張(EGV)的療效。方法 42例EGV患者隨機(jī)分為同步治療組(22例)和序貫治療組(20例),同步治療組采用內(nèi)鏡下改良三明治法治療胃底曲張靜脈后,同時(shí)行食管曲張靜脈套扎術(shù)(EVL),序貫治療組采用內(nèi)鏡下改良三明治法治療胃底曲張靜脈后,隔一周分次行EVL。比較兩組患者內(nèi)鏡下止血成功率、再出血率、胃底靜脈曲張(GV)改善率、套扎器應(yīng)用數(shù)目及腹痛、發(fā)熱、菌血癥和異位栓塞等不良反應(yīng)發(fā)生率。結(jié)果兩組患者內(nèi)鏡下止血成功率、再出血率、GV改善率差異無統(tǒng)計(jì)學(xué)意義,兩組患者胸腹痛、發(fā)熱、菌血癥發(fā)生率差異無統(tǒng)計(jì)學(xué)意義。所有患者均未出現(xiàn)異位栓塞。兩組患者分別平均應(yīng)用(8.19±2.01)與(7.81±1.78)枚套扎環(huán),食管靜脈曲張(EV)消失率分別為59.09%與70.00%,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論內(nèi)鏡下一次性注射組織膠+聚桂醇同步聯(lián)合套扎治療EGV安全有效,并發(fā)癥發(fā)生率低,且可減少內(nèi)鏡檢查次數(shù),減少患者痛苦及醫(yī)療費(fèi)用,值得進(jìn)一步研究。
[Abstract]:Objective to investigate the efficacy of modified sandwich method combined with sequential ligation in the treatment of esophageal and gastric varices (EGV). Methods 42 cases of EGV patients were randomly divided into synchronous treatment group (n = 22) and sequential therapy group (n = 20). Endoscopic modified sandwich method for treatment of varicose gastric fundus, At the same time, the esophageal variceal ligation was performed. The patients in the sequential treatment group were treated with endoscopic modified sandwich method for the treatment of gastric varices. The success rate of endoscopic hemostasis, the rate of rebleeding and the improvement rate of GV were compared between the two groups. Results there was no significant difference between the two groups in the success rate of endoscope hemostasis and the improvement rate of GV. There was no significant difference between the two groups in chest and abdominal pain, fever, fever, and other adverse reactions, such as abdominal pain, fever, bacteremia and ectopic embolism. There was no significant difference in the incidence of bacteremia. No ectopic embolism was found in all the patients. The two groups were treated with an average of 8.19 鹵2.01 and 7.81 鹵1.78 ligation rings, respectively. The disappearance rate of esophageal variceal varices was 59.09% and 70.00.The difference was not statistically significant (P 0.05). Conclusion it is safe and effective to treat EGV with simultaneous injection of tissue colloid and cinnamol under endoscope, the incidence of complications is low, and the frequency of endoscopic examination can be reduced. Reducing patient pain and medical costs is worth further study.
【作者單位】： 山東省臨沂市中心醫(yī)院消化科;
【基金】：山東省醫(yī)藥衛(wèi)生科技發(fā)展計(jì)劃項(xiàng)目(No:2015WS0365)
【分類號】：R575.2

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