内镜下精准食管胃静脉曲张断流术的前瞻性研究（附180例报告）

Prospective study on 180 cases of endoscopic selective varies devascularization

摘要:

前瞻性研究内镜下精准食管胃静脉曲张断流术的临床疗效及安全性。方法 180例肝硬化伴食管胃静脉曲张行内镜下治疗者纳入前瞻性分析，行内镜下精准食管胃静脉曲张断流术。采用改良的“三明治夹心法”，聚桂醇-组织胶-生理盐水，行血管来源支精准断流治疗，观察治疗的显效率、有效率、改善率以及再出血率和并发症发生情况。结果 术后1个月，静脉曲张显效率67.8%（122/180），有效率30.0%（54/180），无效率2.2%（4/180），改善率97.8%（176/180）。术后2周内，再出血率3.3%（6/180）。术后3个月内，再出血率7.2%（13/180）。所有患者均无严重并发症发生，总体并发症发生率37.8%（68/180）。结论 内镜下精准食管胃静脉曲张断流术疗效及安全性较好，值得推广。

Abstract:

To study the clinical efficacy and safety of endoscopic selective varies devascularization prospectively. Methods 180 cases of cirrhosis with esophagogastric variceal endoscopic treatment were included in the prospective analysis. They were treated with selective source of blood vessel devascularization using modified sandwich method (lauromacrogol-tissue adhesive-saline). The improvement rates, effective rates, significant effective rates, rebleeding rates and rates of complications were observed. Results One month after treatment, the significant effective rate of varices was 67.8% (122/180), effective rate was 30.0% (54/180), inefficient rate was 2.2% (4/180) and improvement rate was 97.8% (176/180). Within two weeks after treatment, the rebleeding rate was 3.3% (6/180). Within three months after treatment, the rebleeding rate was 7.2% (13/180). No serious complications occurred. The incidence of overall complication was 37.8% (68/180). Conclusion Endoscopic selective varies devascularization has good efficacy and safety, and is worth promoting.