内镜下套扎、硬化剂单用及联用治疗食管静脉曲张的对比分析

Comparative analysis of the treatment of esophageal varices by ligation, sclerotherapy and combination therapy under endoscope

摘要:

探讨内镜下套扎、硬化剂单用及联用治疗食管静脉曲张的临床效果。方法 回顾性研究该院174例静脉曲张患者，根据治疗方法不同分为3组，每组58例，分别进行套扎治疗、硬化治疗和联合治疗的处理，比较各组患者治疗后门静脉内径、血流速度和血流量的统计学差异。结果 治疗后，3组患者血流速度、血流量和肝功能[总胆红素（Tbil）、血清白蛋白（ALB）、谷丙转氨酶（ALT）含量]指标与术前比较，差异均有统计学意义（P <0.05），治疗后联合组血流速度、血流量和Tbil含量明显高于套扎组和硬化组，ALB和ALT含量明显低于套扎组和硬化组。不同时点比较，3组患者随着时间迁移，血流速度、血流量和Tbil含量明显上升，ALB和ALT含量明显下降（P <0.05）。联合组临床疗效明显优于套扎组和硬化组，且有效率高于套扎组和硬化组患者（P <0.05），联合组患者发热、恶心/呕吐、进食异物感症状发生率明显低于套扎组和硬化组（P <0.05）。结论 套扎治疗和硬化治疗对于静脉曲张患者有一定疗效，联合治疗食管静脉曲张的效果更佳，值得临床推广。

Abstract:

To investigate the clinical effect of endoscopic ligation, sclerotherapy alone and combined treatment of esophageal varices.?Methods?A retrospective study was performed on 174 patients with varicose veins. They were divided into 3 groups according to different treatment methods, and were treated with ligation, sclerotherapy and combination therapy, respectively. Statistical differences in portal vein diameter, blood flow velocity, and blood flow after treatment were compared between groups.?Results?After treatment, the blood flow velocity, blood flow and liver function [total bilirubin (Tbil), serum albumin (ALB), alanine aminotransferase (ALT) content] were significantly different from those before surgery (P < 0.05). After treatment, the blood flow velocity, blood flow and Tbil content in the combined group were significantly higher than those in the ligation group and the sclerosis group. The ALB and ALT levels were significantly lower than those in the ligation group and the sclerosis group. At different time points, blood flow, blood flow and Tbil content increased significantly, and ALB and ALT levels decreased significantly in the three groups (P < 0.05). The clinical efficacy of the combined group was significantly better than that of the ligation group and the sclerotherapy group, and the effective rate was higher than that of the ligation group and the sclerotherapy group (P < 0.05). The incidence of fever, nausea or vomiting, and foreign body sensation was significantly lower in the combined group than ligation group and cirrhosis group (P < 0.05).?Conclusion?Ligation and sclerotherapy have a certain effect on varicose vein treatment, and the combined treatment of esophageal varices is better and worthy of clinical promotion.