【摘要】：目的：回顧性對比分析陜西省人民醫(yī)院消化內(nèi)科近20年來采用不同的硬化劑注射方法治療食管靜脈曲張出血（Esophagogastric varices bleeding,EGVB）的療效、及并發(fā)癥的發(fā)生率，探討止血率更高、并發(fā)癥的發(fā)生率更低的內(nèi)鏡下硬化劑注射方法，從而為臨床在治療EGVB時(shí)采用更安全、治療效果更好的治療方法提供理論依據(jù)。 方法：將陜西省人民醫(yī)院消化內(nèi)科近20年因EGVB經(jīng)硬化劑注射治療的患者根據(jù)硬化劑注射方法不同,分為兩組，對照組（傳統(tǒng)硬化劑治療組，靜脈內(nèi)+靜脈旁注射）：1992~1998年陜西省人民醫(yī)院消化內(nèi)科經(jīng)傳統(tǒng)硬化劑注射方法治療EGVB的病例258例次；改良組(靜脈內(nèi)注射)：2009~2012年陜西省人民醫(yī)院消化內(nèi)科經(jīng)改良后的硬化劑注射方法治療EGVB的病例268例次，對比分析兩組硬化劑注射治療EGVB的止血成功率、治療后的總體并發(fā)癥發(fā)生率。 結(jié)果： 1、改良組（靜脈內(nèi)注射）治療食管靜脈曲張出血的止血率為98.5%，而對照組（靜脈內(nèi)+靜脈旁注射）的止血率為97.6%，兩組采用χ2檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)分析，P＞0.05無統(tǒng)計(jì)學(xué)差異。 2、改良組硬化劑注射治療后并發(fā)癥的發(fā)生率為17.2%，對照組硬化劑注射治療后的并發(fā)癥發(fā)生率為43.4%，改良組（靜脈內(nèi)注射）治療后的并發(fā)癥發(fā)生率較對照組（靜脈內(nèi)+靜脈旁注射）降低，經(jīng)χ2檢驗(yàn)分析，兩組差異具有統(tǒng)計(jì)學(xué)意義。 結(jié)論：內(nèi)鏡下硬化劑注射法（Endoscopic injection sclerotherapy,EIS）治療食管靜脈曲張出血安全、有效、止血率高，但是傳統(tǒng)的硬化劑注射方法（靜脈內(nèi)+靜脈旁注射）治療后并發(fā)癥（如發(fā)熱、食管潰瘍）的發(fā)生率較高，陜西省人民醫(yī)院消化內(nèi)科經(jīng)改進(jìn)硬化劑注射方法后采用靜脈內(nèi)快速注射硬化劑，經(jīng)改良后的EIS并沒有降低硬化劑注射治療EGVB的高止血率，并且在高止血率基礎(chǔ)上降低了治療后并發(fā)癥（如發(fā)熱、食管潰瘍）的發(fā)生率，使EIS治療EGVB的技術(shù)更成熟，，安全性更高，并發(fā)癥發(fā)生率更低，更值得臨床應(yīng)用。
[Abstract]:Objective: to compare and analyze retrospectively the curative effect of different sclerosing agent injection for esophageal variceal hemorrhage (Esophagogastric varices bleeding,EGVB) and the incidence of complications in the Department of Gastroenterology of Shaanxi Provincial people's Hospital in recent 20 years, and to explore the higher hemostatic rate. The lower incidence of complications of endoscopic sclerosing agent injection method for the clinical treatment of EGVB is safer and better treatment methods to provide a theoretical basis. Methods: the patients treated with sclerosing agent for EGVB in recent 20 years in the Department of Digestive Medicine of Shaanxi Provincial people's Hospital were divided into two groups according to the different methods of sclerosing agent injection: the control group, the traditional sclerosing agent group, and the control group. Intravenously): from 1992 to 1998, 258 cases of EGVB were treated by traditional sclerosing agent injection in the Department of Digestive Medicine, Shaanxi Provincial people's Hospital; Improvement group (intravenous injection): 268 cases of EGVB were treated with modified sclerosing agent injection method in Department of Gastroenterology, Shaanxi Provincial people's Hospital from 2009 to 2012. The hemostatic success rate of two groups of sclerosing agent injection for EGVB was compared and analyzed. Overall incidence of complications after treatment. Results: 1. The hemostatic rate of the modified group (intravenously injected) for esophageal variceal bleeding was 98.5 and that of the control group was 97.60.The two groups were statistically analyzed by 蠂 2 test. P > 0.05 there was no statistical difference. 2. The incidence of complications after sclerosing agent injection was 17.2in the modified group and 43.4 in the control group. The incidence of complications in the modified group (intravenously injected) was lower than that in the control group. The difference was statistically significant by 蠂 2 test. Conclusion: endoscopic sclerosing agent injection (Endoscopic injection sclerotherapy,EIS) is safe, effective and effective in the treatment of esophageal variceal bleeding. However, the traditional injection of sclerosing agent (intravenously injection) is safe, effective and effective in the treatment of complications (such as fever). The incidence of esophageal ulcers) was high. After improving the injection method of sclerosing agent, the Department of Digestive Medicine of Shaanxi Provincial people's Hospital adopted fast intravenously injection of sclerosing agent, but the modified EIS did not reduce the high hemostatic rate of EGVB treated with sclerosing agent injection. On the basis of high hemostasis rate, the incidence of post-treatment complications (such as fever, esophageal ulcer) was reduced. The technique of EIS in treating EGVB was more mature, the safety was higher, and the incidence of complications was lower, which was more worthy of clinical application.
【學(xué)位授予單位】：延安大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R571.3

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