胃镜下聚桂醇注射联合套扎术治疗食管胃底静脉曲张的临床观察

The effect of gastroscopic lauromacrogol injection combined with ligation on the portal vein hemodynamics in patients with esophageal gastric varices

摘要:

目的 探讨胃镜下聚桂醇注射联合套扎术治疗肝硬化食管胃底静脉曲张（EGV）的疗效和安全性。方法 2016年1月至2018年1月，西安高新医院消化内科连续收治的肝硬化EGV患者作为研究对象，采用随机数字表法分为单纯套扎组和硬化联合套扎组，每组50例。单纯套扎组仅行胃镜下静脉曲张套扎术治疗，硬化联合套扎组术中行胃镜下静脉曲张套扎术治疗前先完成聚桂醇注射治疗。主要对比分析2组门静脉血流动力学测定结果，术后7 d、3个月、6个月的疗效评估结果，术后并发症发生情况。结果 单纯套扎组和硬化联合套扎组术后门静脉血流速度[（23.87±2.57）cm/s比（26.52±2.71）cm/s,t=5.017,P＜0.001]、血流量[（781.45±80.55）mL/min比（877.45±90.42）mL/min,t=5.606,P＜0.001]比较差异均有统计学意义，且2组均明显高于术前（P均＜0.05）。2组术后7 d治疗有效率分别为96%（48/50）和100%（50/50）（χ2=2.041，P=0.153），术后3个月分别为84%（42/50）和96%（48/50）（χ2=4.000，P=0.046），术后6个月分别为76%（38/50）和92%（46/50）（χ2=4.762，P=0.029）。2组术后并发症总体发生率分别为14%（7/50）和20%（10/50）（χ2=0.638，P=0.424）。结论 胃镜下聚桂醇注射联合套扎术治疗肝硬化EGV安全有效，较胃镜下静脉曲张套扎术优势在于患者门静脉血流动力学改善更明显、疗效更稳定。

Abstract:

Objective: To discuss the effect of gastroscopic lauromacrogol injection combined with ligation on the portal vein hemodynamics in patients with esophageal gastric varices (EGV). Methods: 100 patients with EGV were selected from January 2016 to January 2018 in our Hospital, according to the random number table method, they were divided into ligation group and lauromacrogol ligation group, 50 cases in each group, ligation group was treated with gastroscopic ligation, lauromacrogol ligation group was treated with gastroscopic lauromacrogol injection on the basis. The portal vein hemodynamics, therapeutic effect and complications of the two groups were compared. Results: The postoperative portal vein blood flow velocity and blood flow in the ligation group and lauromacrogol ligation group were significantly higher than those in the preoperative, the postoperative portal vein blood flow velocity and blood flow in the lauromacrogol ligation group were significantly higher than those in the ligation group, the difference was statistically significant (P < 0.05). The 3 and 6 months postoperative treatment effective rate in the lauromacrogol ligation group were significantly higher than those in the ligation group, the difference was statistically significant (P < 0.05). The comparison of the complication rate between the ligation group and lauromacrogol ligation group, the difference was not statistically significant (P > 0.05). Conclusions: Gastroscopic lauromacrogol injection combined with ligation can effectively improve the portal vein hemodynamics in patients with EGV, which is conducive to improving the curative effect of patients, and it has the good safety, it’s worth for further clinical promotion.