食管曲张静脉内镜套扎术影响门脉高压性胃病研究.docVIP

食管曲张静脉内镜套扎术影响门脉高压性胃病研究 　　[摘要] 目的 探讨采用食管曲张静脉内镜下实施套扎术对治疗门脉高压性胃病（PHG）的安全性和有效性。 方法 选取2008年1月～2012年12月我院收治的180例肝硬化合并门脉高压症患者作为观察对象，全部病例均采用内镜下套扎术治疗，观察不同肝功能分级患者采用食管曲张静脉内镜下实施套扎术的治疗效果，对比术前及术后4个月、8个月、12个月的门脉高压性胃病复发率。 结果 A级与B级患者PHG严重程度差异不显著（P 0.05）；A级、B级与C级患者PHG严重程度差异显著（P 0.05）；术后4个月的PHG复发率最低，术后8个月、12个月的PHG复发率逐渐增高。 结论 食管曲张静脉内镜套扎术能降低肝硬化合并上消化道出血患者术后再出血率，该术式治疗效果与肝功能分级密切相关，临床治疗前可结合肝功能Child-Pugh分级评价预期疗效，改善动态治疗效果。 　　[关键词] 肝硬化；门脉高压性胃病；内镜下套扎术；食管曲张静脉 　　[中图分类号] R575.2 [文献标识码] B [文章编号] 1673-9701（2013）32-0146-02 　　Influence of endoscopic esophageal variceal ligation in the treatment of portal hypertension gastropathy 　　LI Zhuojiang 　　Department of Digestive Internal Medicine， Xinhui District Peoples Hospital of Jiangmen City in Guangdong Province， Jiangmen 529100， China 　　[Abstract] Objective To explore the safety and efficacy of endoscopic esophageal variceal ligation in the treatment of portal hypertension gastropathy （PHG）. Methods A total of 180 cases of hepatocirrhosis with portal hypertension patients， admitted in our hospital from January 2008 and December 2012 were seleted as the study objects， all the patients received the treatment of endoscopic ligation， the therapeutic effect of patients with different classification of liver function were observed， and the recurrence rates of portal hypertension gastropathy before the surgery， 4 months， 8 months and 12 months after the surgery were compared. Results There was no significant difference between grade A and grade B in the severity of PHG （P 0.05）； and there were significant differences in grade A， B and C （P 0.05）； after 4 months of surgery， the recurrence rates of PHG was lowest， and it increased gradually at 8 months and 12 months. Conclusion Endoscopic esophageal variceal ligation can reduce the postoperative rebleeding rate， and the currative effects are closely related with liver function classification， so we can evaluate the effect according to Child-Pugh of liver function before the surgery， and expect to impr