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目的观察内镜下套扎术(esophageal variceal ligation,EVL)联合药物治疗食管胃底静脉曲张出血(esophagogastric varices,EGV)的临床效果。方法选取2015年1月—2017年1月收治的EGV患者100例,根据随机数表法分为观察组及对照组,每组50例。观察组实施EVL手术联合药物治疗,对照组实施药物保守治疗。观察并比较两组止血成功率、再次出血率及复发率,止血成功评价标准:实施ELV治疗后,经胃镜检查显示食管静脉曲张消失。记录并比较两组术后并发症发生情况,包括:食管溃疡及门脉高压性胃病等。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组止血成功率为96%,与对照组的92%比较,差异无统计学意义(P<0.05);观察组再次出血率及复发率分别为4%、6%,明显低于对照组的20%、24%,差异有统计学意义(P<0.05);观察组食管溃疡、门脉高压性胃病等并发症发生率分别为4%、4%,低于对照组的20%、20%,差异有统计学意义(P<0.05)。结论内镜下套扎术联合药物治疗食管胃底静脉曲张出血临床效果较单纯药物保守治疗好,患者术后并发症少,再次出血及复发风险低,疗效显著,安全性好。
Objective To observe the clinical effect of esophageal variceal ligation (EVL) combined with drugs on esophagogastric varices (EGV). Methods 100 patients with EGV admitted from January 2015 to January 2017 were divided into observation group and control group according to the random number table method, with 50 cases in each group. The observation group was treated with EVL combined with drug therapy and the control group with conservative drug treatment. Observed and compared the success rate of hemostasis, re-bleeding rate and recurrence rate, success rate of hemostasis Evaluation criteria: After ELV treatment, esophageal varices disappeared by gastroscopy. Record and compare the postoperative complications of two groups, including: esophageal ulcer and portal hypertensive gastropathy. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The success rate of hemostasis in the observation group was 96%, which was not significantly different from that in the control group (92%) (P <0.05). The rebleeding rate and recurrence rate in the observation group were 4% and 6% (P <0.05). The incidences of complications such as esophageal ulcer and portal hypertensive gastropathy in the observation group were 4% and 4%, respectively, which were lower than those in the control group (20% and 20%, respectively) %, The difference was statistically significant (P <0.05). Conclusion The clinical efficacy of endoscopic ligation combined with drug treatment of esophageal and gastric variceal bleeding is better than simple conservative treatment. The patients have fewer postoperative complications, low risk of rebleeding and recurrence, significant curative effect and good safety.