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目的探讨内镜下组织胶注射序贯套扎治疗Le,g型食管胃静脉曲张中长期疗效。方法选取解放军总医院及海南分院消化内科2013年5月—2015年5月收治的55例符合LDRf分型中Le,g型食管胃静脉曲张患者,采用内镜下组织胶序贯套扎法进行治疗,选取术后6~12个月、12~24个月、24~36个月为时间节点进行为期3年随访,持续追踪患者食管胃静脉曲张的复发率、再发出血率以及因静脉曲张破裂出血死亡率等。结果随访6~12个月期间,食管静脉曲张再发率为9.1%,出血率为3.6%,死亡率为1.8%;12~24个月期间,食管静脉曲张再发率为18.9%,出血率为5.7%,死亡率为3.8%;24~36个月期间食管静脉曲张再发率为6.1%,出血率为2.0%,死亡率为0。结论内镜下组织胶序贯套扎治疗食管胃曲张静脉相通的Le,g型病例中长期复发率、出血率及出血导致死亡率均较低,再发出血风险可控。
Objective To investigate the medium and long term effects of endoscopic injection of tissue glue in the treatment of Le, g esophagogastric varices. Methods 55 patients with Le, g type gastroesophageal varices in the Department of Gastroenterology, General Hospital of PLA and Hainan Branch from May 2013 to May 2015 were enrolled in this study. The patients were followed up for 6 to 12 months, 12 to 24 months and 24 to 36 months respectively. The patients were followed up for the recurrence rate of esophagogastric varices, Rupture of bleeding mortality and so on. Results The follow-up ranged from 6 to 12 months. The recurrence rate of esophageal varices was 9.1%, the bleeding rate was 3.6% and the mortality rate was 1.8%. The recurrence rate of esophageal varices was 18.9% between 12 and 24 months. The bleeding rate 5.7% and the mortality rate was 3.8%. The recurrence rate of esophageal varices was 6.1%, the bleeding rate was 2.0% and the mortality rate was 0 during 24-36 months. Conclusions Long-term recurrence rate, hemorrhage rate and hemorrhage-induced mortality are both low and recurrence risk in patients with Le, g type of esophagogastric varices through endoscopic ligation of gastric mucosa.