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前瞻性研究内镜下重复注射硬化剂疗法 (EIS)及联合应用内镜下套扎术 (EVL +EIS)两种治疗方法的安全性、疗效、并发症和复发率。方法 51例肝硬化患者符合研究对象 ,随机分为两组 :A组 (EIS组 ) 2 5例 ,B组 (EVL+EIS组 ) 2 6例 ,前组每周重复使用 1%乙氧硬化醇行EIS治疗 ,直至所有曲张静脉均消失 ,后组第一次行EVL ,1周后每周行EIS治疗。结果 EIS及EVL +EIS两组中 ,食管曲张静脉消失率分别为 84 %和 76.9% ,治疗次数分别为 ( 4.2±1.6)次和 ( 3 .0± 0 .4 )次 ,住院时间分别为 ( 4.6± 1.4 )周和 ( 4.5± 1.1)周 ,都无显著性差异。硬化剂使用总量B组显著低于A组 ,分别为 ( 2 2 .6± 8.2 )ml和 ( 42± 10 .5)ml,(P <0 .0 1)。在治疗期间并发症的发生率B组显著低于A组 (P <0 .0 1)。胃镜随访发现食管下端形成环形溃疡和继发性瘢痕 ,其发生率B组较A组为低 ,分别为 2 0 %和 90 .5% ,差异有显著性 (P <0 .0 1)。在平均 12 .5个月的随访中 ,食管静脉曲张复发率B组显著高于A组 ,分别为 4 0 %和 9.5% ,(P <0 .0 5)。结论 EVL +EIS组并发症较少 ,而EIS组在预防静脉曲张复发方面较EVL +EIS组更为优越
Prospective study of endoscopic repeated sclerosis (EIS) and combined endoscopic ligation (EVL + EIS) two kinds of treatment of safety, efficacy, complications and recurrence rate. Methods Fifty-one patients with cirrhosis were randomly divided into two groups: 25 in group A (EIS group) and 26 in group B (EVL + EIS group). The former group was treated with 1% EIS treatment until all the varicose veins disappeared, after the first group of EVL, 1 week after the line EIS treatment. Results In the EIS and EVL + EIS groups, the disappearance rates of esophageal varices were 84% and 76.9%, respectively, and the treatment times were (4.2 ± 1.6) and (3.0 ± 0.4) times, respectively. The hospitalization time was ( 4.6 ± 1.4) weeks and (4.5 ± 1.1) weeks, there was no significant difference. The total amount of hardener used in group B was significantly lower than that in group A (22.6 ± 8.2) ml and (42 ± 10.5) ml, respectively (P <0.01). The incidence of complications during treatment was significantly lower in group B than in group A (P <0.01). Gastroscopy follow-up found that the lower end of the esophagus formed annular ulcers and secondary scars, the incidence of group B compared with the A group was low, respectively 20% and 90.5%, the difference was significant (P <0.01). In an average of 12.5 months of follow-up, esophageal varices recurrence rate was significantly higher in group B than in group A, 40% and 9.5%, respectively (P <0.05). Conclusion There were fewer complications in EVL + EIS group, while EIS group was superior to EVL + EIS group in preventing recurrence of varicose vein