本文選題：肝硬化 + 胃靜脈曲張出血��； 參考：《中國(guó)內(nèi)鏡雜志》2017年02期

【摘要】：目的探討胃鏡下組織膠注射治療肝硬化胃靜脈曲張破裂出血的臨床療效及安全性。方法研究對(duì)象為2014年6月-2016年5月住院經(jīng)胃鏡確診的肝硬化胃靜脈曲張破裂出血的患者92例。其中,男72例,女20例。92例肝硬化患者的肝功能Child-Pugh分級(jí):A級(jí)28例,B級(jí)36例,C級(jí)28例。胃鏡下胃曲張靜脈分型:GEV 1型80例,GEV 2型12例。所有患者均采用胃鏡下高滲糖組織膠"三明治"夾心法注射治療。結(jié)果 (1)92例肝硬化胃靜脈曲張破裂出血的患者胃鏡下組織膠注射治療成功率100.0%,其中急診胃鏡下組織膠注射治療的患者40例,即時(shí)止血率100.0%。65例患者術(shù)后6個(gè)月復(fù)查胃鏡:顯效22例,占33.8%;有效38例,占58.5%;無(wú)效5例,占7.7%。全部患者隨訪1~24個(gè)月,無(wú)早期再出血患者,晚期再出血率2.2%,無(wú)患者死亡;(2)并發(fā)癥:組織膠注射治療術(shù)中拔針出血發(fā)生率2.2%,術(shù)后胸痛發(fā)生率4.3%,腹脹發(fā)生率6.5%,排膠潰瘍發(fā)生率15.2%,無(wú)發(fā)熱、感染、腹痛和異位栓塞等并發(fā)癥發(fā)生。結(jié)論胃鏡下組織膠注射治療肝硬化胃靜脈曲張破裂出血的療效確切,止血效果好,不良反應(yīng)輕,再出血發(fā)生率低。
[Abstract]:Objective to investigate the clinical efficacy and safety of gastroscopic injection of tissue glue in the treatment of hepatic cirrhosis and gastric variceal hemorrhage. Methods from June 2014 to May 2016, 92 patients with gastric variceal bleeding from cirrhosis diagnosed by gastroscopy were enrolled in the study. Among them, there were 72 males and 20 females. 28 cases of liver function were classified as Child-Pugh grade A (28 cases) and B grade (36 cases) and C grade (28 cases). Gastroscopic classification of gastric varices type 1: GEV 1 in 80 cases and GEV 2 in 12 cases. All patients were treated with sandwich method under gastroscopy. Results (1) the success rate of endoscopic tissue glue injection was 100.0% in 92 patients with gastroesophageal variceal bleeding, 40 of whom were treated with emergency gastroscopic tissue glue injection. The immediate hemostasis rate was 100.0.65 patients were examined by gastroscope 6 months after operation: 22 cases were markedly effective (33.8%), 38 cases were effective (58.5%), 5 cases were ineffective (7.7%). All the patients were followed up for 1 to 24 months. The rate of late rebleeding was 2.2 and there was no death. (2) complications: the incidence of bleeding during the treatment of tissue glue injection was 2.2, the incidence of postoperative chest pain was 4.3, the incidence of abdominal distension was 6.5 and the incidence of gumming ulcer was 15.2. there were no complications such as fever, infection, abdominal pain and ectopic embolism. Conclusion Gastroscopic injection of tissue glue in the treatment of hepatic cirrhosis gastric variceal bleeding is effective, the hemostatic effect is good, the adverse reaction is light, and the incidence of rebleeding is low.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院消化內(nèi)科;
【分類(lèi)號(hào)】：R575.2

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