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目的:探讨内镜下治疗联合部分脾栓塞序贯治疗食管-胃底静脉曲张破裂出血的效果和安全性。方法:肝硬化食管-胃底静脉曲张破裂出血合并脾功能亢进患者86例随机分为2组,治疗组52例,分别序贯进行内镜下套扎、硬化剂注射、组织黏合剂栓塞及部分脾栓塞治疗;对照组34例,单纯内镜下套扎、硬化剂注射、组织黏合剂栓塞治疗;比较术后急诊止血率、曲张静脉消失率、曲张静脉复发率、并发症发生率等指标。结果:治疗组与对照组急诊止血率均为100%,并发症发生率分别为15.4%,14.7%,差异无统计学意义(P>0.05);治疗组与对照组曲张静脉消失率分别为92.3%,76.5%,曲张静脉复发率分别为11.5%,41.2%,2组比较差异有统计学意义(P<0.05)。结论:内镜下治疗联合部分脾栓塞序贯治疗食管胃底静脉曲张破裂出血安全有效。
Objective: To investigate the efficacy and safety of endoscopic treatment of partial splenic embolization in the treatment of esophageal-gastric variceal bleeding. Methods: Eighty-six patients with esophageal-gastric variceal hemorrhage complicated with hypersplenism of liver cirrhosis were randomly divided into two groups. The treatment group received 52 cases of ligation, sclerotherapy, tissue adhesive embolization and partial embolization Splenic embolization; control group of 34 cases, endoscopic ligation, sclerotherapy, tissue adhesive embolization; comparison of postoperative emergency hemostasis rate, varicose vein disappearance rate, varicose vein recurrence rate, complication rate and other indicators. Results: The hemostatic rate of the treatment group and the control group were all 100%, the complication rates were 15.4% and 14.7% respectively, with no significant difference (P> 0.05). The disappearance rates of varicose veins in the treatment group and the control group were 92.3 %, 76.5%. The recurrence rates of varicose veins were 11.5% and 41.2% respectively. There was significant difference between the two groups (P <0.05). Conclusion: Endoscopic treatment of partial splenic embolization sequential treatment of esophageal varices bleeding is safe and effective.