硬化剂和组织胶在治疗食管胃底静脉曲张中的疗效观察.docVIP

硬化剂和组织胶在治疗食管胃底静脉曲张中的疗效观察 王铁武，李西梅，董琳，刘晗，高瑞萍 【摘要】目的 评估内镜下注射硬化剂（鱼肝油酸钠或聚桂醇）与组织黏合剂治疗食管胃底静脉曲张的近期及远期疗效。方法 对278例内镜下介入治疗的食管胃底静脉曲张患者的临床资料进行回顾性分析，分为鱼肝油酸钠治疗组、聚桂醇治疗组与组织黏合剂治疗组。结果 聚桂醇治疗组与鱼肝油酸钠组、组织黏合剂治疗组的止血成功率、近期及远期再出血率进行组间比较，P＞0.05，差异无统计学意义。硬化剂与组织黏合剂治疗组静脉曲张改善有效率和并发症发生率比较，差异具有统计学意义（P＜0.05）。结论 内镜下单独注射鱼肝油酸钠、聚桂醇或组织黏合剂治疗食管胃底静脉曲张均能有效止血，且可预防再出血的发生，而聚桂醇在有效消除静脉曲张及并发症发生方面优于鱼肝油酸钠、组织黏合剂。 【关键词】 食管胃底静脉曲张；静脉曲张硬化治疗术；聚桂醇；组织黏合剂 【中图分类号】R573.2 【文献标识码】 A Comparing the curative effects of sclerotherapy and injection of cyanoacrylate in esophageal and gastric varices WANG Tie ? wu，LI Xi ? mei，Dong Lin，LIU Han，GAO Rui ? ping﹙Ningxia Peoples Hospital，Yinchuan 750021﹚ ［Abstract］ Objective To evaluate the recent and long-term curative effects of endoscopic variceal sclerotherapy ﹙sodium morrhuate or lauromacrogol﹚and endoscopic injection of cyanoacrylate in esophageal and gastric varices. Methods The clinical data of 278cases endoscopic treatment were analyzed retrospectively，the curative effect were compared in endoscopic variceal sclerotherapy ﹙sodium morrhuate or lauromacrogol﹚and endoscopic injection of cyanoacrylate. Results There were no significant differences in short and long term therapeutic efficacy among the three groups ﹙P 0. 05﹚. The rates of effectively eliminate varices and complications were significantly differences among the three groups ﹙P 0. 05﹚. Conclusion Endoscopic variceal sclerotherapy ﹙sodium morrhuate or lauromacrogol﹚and injection of cyanoacrylate can effecti- -vely stanch and prevent rebleeding. Lauromacrogol are obviously superior to the sodium morrhu- -ate and cyanoacrylate in effectively eliminate varices and complications. ［Key words］ Esophageal and gastric varices，Endoscopic variceal sclerotherapy，Lauromacrogol，Cyanoacrylate 内镜下治疗食管胃底静脉曲张的方法较多，鱼肝油酸钠、聚桂醇等硬化剂注射和组织黏合剂栓塞治疗均已有多年的发展历史。为进一步探讨三种疗法的治疗效果，为临床上治疗方案的选择提供依据，现就我院收治的278例食管胃底静脉曲张患者的疗效进行比较分析。 1 资料与方法 1.1 一般资料：收集我院2000年6月1日-2010年1月1日采用硬化剂和组织黏合剂治疗的食管胃底静脉曲张患者的临床资料，其中5%鱼肝油酸钠硬化治疗术138例，聚桂醇硬化治疗术122例，组织黏合剂栓塞术18例。所有病例均于出血后72h内行常规胃