王艺霖

【摘要】 目的：观察微创治疗在肝硬化门脉高压症并食管胃静脉曲张患者治疗中的临床效果。方法：选取笔者所在医院收治的80例肝硬化门脉高压症并食管胃静脉曲张患者。根据患者治疗方法，将40例采用胃镜下硬化剂注射术治疗的患者作为对照组，将40例采用食管胃静脉曲张内镜下套扎术治疗的患者作为研究组。对比两组止血成功率及治疗前后血流动力学指标。结果：治疗后研究组止血成功率高于对照组，差异有统计学意义（P<0.05）;治疗前两组平均动脉压和中心静脉压比较差异无统计学意义（P>0.05），治療后研究组平均动脉压和中心静脉压均优于对照组，差异均有统计学意义（P<0.05）。结论：在针对肝硬化门脉高压症并食管胃静脉曲张患者进行治疗的过程中，采用食管胃静脉曲张内镜下套扎术能够有效提高治疗效果，改善血流动力学指标，值得推广。

【关键词】 肝硬化门脉高压症 食管胃静脉曲张 微创治疗 临床疗效

doi：10.14033/j.cnki.cfmr.2020.17.051 文献标识码 B 文章编号 1674-6805（2020）17-0-03

Clinical Observation of Minimally Invasive in Treatment of Cirrhosis and Portal Hypertension with Esophageal and Gastric Varices/WANG Yilin. //Chinese and Foreign Medical Research， 2020， 18（17）： -122

[Abstract] Objective： To observe the clinical effect of minimally invasive treatment in patients with cirrhosis and portal hypertension with esophageal and gastric varices. Method： A total of 80 patients with cirrhosis and portal hypertension with esophageal and gastric varices admitted to our hospital were selected. According to the treatment time of patients， 40 patients treated with gastro-sclerosis injection were set to the control group， 40 patients with esophageal and gastric varices treated by endoscopic ligation were set to the study group. The success rate of hemostasis and the hemodynamic indexes before and after treatment were compared between the two groups. Result： After treatment， the success rate of hemostasis in the study group was higher than that in the control group， the difference was statistically significant （P<0.05）. There was no statistically significant difference in the mean arterial pressure and central venous pressure between the two groups before treatment （P>0.05）， the mean arterial pressure and central venous pressure in the study group were better than those in the control group after treatment， the differences were statistically significant （P<0.05）. Conclusion： In the process of treating patients with cirrhosis and portal hypertension and esophageal and gastric varices， the use of esophageal and gastric varicose endoscopy can effectively improve the treatment effect and improve the hemodynamic indexes of patients， which is worth of promotion.

[Key words] Cirrhosis and portal hypertension Esophageal and gastric varices Minimally invasive treatment Clinical efficacy

First-authors address： Foshan First Peoples Hospital， Foshan 528000， China

食管胃静脉曲张破裂出血是导致失代偿期肝硬化患者死亡的主要原因。根据相关调查研究表明，约有半数患者会出现食管胃静脉曲张的症状，而食管胃静脉曲张患者首次破裂出血时其病死率约在30%，再出血发生率约在60%，病死率为30%～70%[1]。在该病的临床治疗中，随着医疗技术的发展，现阶段微创治疗被越来越多的应用在临床中，目前也已经被列为食管胃静脉曲张破裂出血初、次级预防的首选方式[2]。本次选取80例肝硬化门脉高压症并食管胃静脉曲张患者，对不同治疗方式的效果进行了研究，具体如下。

1 资料与方法

1.1 一般资料

选取笔者所在医院2018年1月-2019年1月收治的80例肝硬化门脉高压症并食管胃静脉曲张患者。纳入标准：符合肝炎后肝硬化诊断标准;经胃镜检查或上消化道X线钡餐检查发现不同程度食管胃静脉曲张;经临床诊断上消化道出血原因为食管胃静脉曲张破裂[3]。……