张晓庆

[摘要] 目的 探讨内镜下精准食管胃静脉曲张断流术与传统序贯注射治疗食管胃底静脉曲张破裂出血的效果。 方法 选取2018年2月至2020年2月我院接受治疗的98例食管胃底静脉曲张破裂出血患者，随机分为研究组和对照组，每组各49例。对照组给予传统序贯注射治疗，研究组给予内镜下精准食管胃静脉曲张断流术治疗。观察比较两组治疗效果、并发症发生率、静脉曲张消失情况以及止血和再出血率等。 结果 研究组的治疗总有效率为95.9%，高于对照组的69.4%，差异有统计学意义（P<0.05）;研究组的再出血率为8.2%、静脉曲张消失率为65.3%，高于对照组的8.2%、65.3%，差异有统计学意义（P<0.05）;研究组的止血率为85.7%，对照组的止血率为83.7%，差异无统计学意义（P>0.05）;研究组的并发症总发生率为24.5%，对照组的并发症总发生率为26.5%，差异无统计学意义（P>0.05）。 结论 食管胃底静脉曲张破裂出血患者应用内镜下精准食管胃静脉曲张断流术治疗可有效增强治疗效果，提高静脉曲张消失率，可推广使用。

[关键词] 内镜;精准食管胃静脉曲张断流术;传统序贯注射;止血率

[中圖分类号] R575.2          [文献标识码] B          [文章编号] 1673-9701（2021）32-0102-03

[Abstract] Objective To investigate the effect of endoscopic selective varices devascularization and traditional sequential injection in the treatment of esophageal and gastric evarices bleeding. Methods A total of 98 patients with esophageal and gastric evarices bleeding who were treated in our hospital from February 2018 to February 2020 were selected and randomly divided into the study group and the control group， with 49 cases in each group. The control group was given traditional sequential injection therapy. The study group was given endoscopic selective varices devascularization. The therapeutic effect， the rate of complications， the disappearance of varicose veins， and the rate of hemostasis and rebleeding in the two groups were observed and analyzed. Results The total effective rate of treatment in the study group was 95.9%， which was higher than that （69.4%） of the control group. The difference between the two groups was statistically significant（P<0.05）. The rebleeding rate and varicose vein disappearance rate in the study group was 8.2% and 65.3%， higher than that of the control group， and the difference between the two groups was statistically significant（P<0.05）. The hemostatic rate in the study group and the control group was 85.7% and 83.7%， respectively. The difference between the two groups was not statistically significant（P>0.05）. The total complication rate in the study group and in the control group was 24.5% and 26.5%， and the difference between the two groups was not statistically significant（P>0.05）. Conclusion Endoscopic selective varices devascularization for patients with esophageal and gastric evarices bleeding can effectively enhance the therapeutic effect and further increase the disappearance rate of varices， which can be promoted.

[Key words] Endoscopy; Endoscopic selective varices devascularization; Traditional sequential injection; Hemostasis rate

肝硬化失代偿期最常见并发症为食管胃底静脉曲张破裂出血，患者发病之后病情比较危重[1-2]。当前临床上多使用手术、介入、内镜以及药物等方式对患者实施治疗，但是药物治疗的整体效果同临床预期之间有一定差距。近几年来内镜技术逐渐完善，断流术因止血效果强、操作简易等优势在临床治疗中的应用也越来越普遍[3]。……