前视超声内镜治疗食管-胃底静脉曲张的初步研究

Preliminary study on the treatment of esophageal and gastric varices by forward-viewing echoendoscope

摘要:

目的 探讨前视超声内镜在食管-胃底静脉曲张（EGV）诊疗中的优势。方法 选取2019年5月－2021年5月郑州大学第一附属医院消化内科收治的EGV患者40例，行前视超声内镜引导下治疗的为观察组（n = 19），普通内镜下治疗的为对照组（n = 21）。术后随访3～6个月，比较两组患者组织胶使用情况、术后并发症、治疗效果和再出血情况等。结果 观察组组织胶注射次数及用量均较对照组少，两组患者比较，差异有统计学意义（P < 0.05）。术后均无严重并发症发生，两组患者并发症总发生率比较，差异无统计学意义（P > 0.05）。术后72 h～3个月，观察组总出血率为10.52%，与对照组的19.05%比较，差异无统计学意义（P > 0.05）。术后1个月所有患者复查胃镜，观察组中治疗效果显著、一般和无效的占比分别为63.16%、31.58%和5.26%，与对照组的33.33%、38.10%和28.57%比较，差异有统计学意义（P < 0.05）。结论 前视超声内镜引导下治疗EGV，较普通内镜可减少组织胶用量，提高治疗效果。

Abstract:

Objective To investigate the advantages of forward-viewing echoendoscope in treatment of esophageal and gastric varices (EGV).Methods 40 patients with EGV from May 2019 to May 2021 were retrospectively analyzed. 19 patients were divided into the observation group and treated by forward-viewing echoendoscope, 21 patients were divided into control group were treated by the ordinary endoscope. After the operation, all the patients were followed up for 3 ~ 6 months. The amount of tissue adhesive, postoperative complications, treatment outcomes and postoperative rebleeding were compared respectively.Results The number of tissue adhesive injections and the amount used by patients in the observation group were less than those in the control group, the differences were statistically significant (P < 0.05). None of the patients had any serious complications after the operation, and the differences in the overall complication rate was not statistically significant (P > 0.05). The total bleeding rate was 10.52% in the observation group and 19.05% in the control group from 72 h to 3 months after operation, and the differences was not statistically significant (P > 0.05). The apparent efficiency, effective rate and inefficiency were 63.16%, 31.58% and 5.26% in the observation group, and there were 33.33%, 38.10% and 28.57% in the control group respectively, the differences between the two groups were statistically significant (P < 0.05).Conclusion The treatment of EGV under the guidance of forward-viewing echoendoscope can reduce the amount of tissue adhesive and improve treatment effect compared with ordinary endoscopy.