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目的:探讨黏合剂治疗胃底静脉曲张对门脉高压性胃病(portal hypertensive gastropathy,PHG)的影响。方法:收集2013年1月至2015年8月乙型肝炎(乙肝)后肝硬化失代偿具有食管胃静脉曲张(GOV)或孤立性胃静脉曲张(IGV)的患者171例,应用硬化剂+黏合剂+硬化剂的改良“三明治”注射治疗法治疗。在治疗后3个月、6个月及1年随访,观察内镜治疗效果以及PHG的发生率变化。结果:171例患者进行内镜下硬化治疗共242例次。术后6个月治疗的有效率为98.8%(169例),术后12个月的有效率为88.9%(152例),存活率为98.2%(168例)。治疗前PHG的总发生率为35.5%,治疗3个月后,发生率为38.1%,与治疗前比较无显著性差异(P>0.05);治疗6个月及1年后,发生率分别为48.0%及84.2%,与治疗前相比,有显著性差异(P<0.05)。结论:胃底静脉曲张硬化治疗明显减少急性出血的死亡率,延长生存时间。PHG的发生率在黏合剂治疗后会有明显上升,需要采取多种联合治疗的方法减少PHG的发生,提高PHG患者的生活质量及生存率。
Objective: To investigate the effect of adhesives on portal hypertensive gastropathy (PHG) in patients with gastric varices. Methods: A total of 171 patients with decompensated liver cirrhosis with esophageal varices (GOV) or isolated gastric varices (IGV) from January 2013 to August 2015 were enrolled in this study. They were treated with sclerotherapy + Binder + Hardener Improved “Sandwich” Injection Therapy Treatment. After 3 months, 6 months and 1 year follow-up, the effect of endoscopic treatment and the incidence of PHG were observed. Results: A total of 242 patients underwent endoscopic sclerotherapy in 171 patients. Six months after operation, the effective rate was 98.8% (169 cases). The effective rate was 88.9% (152 cases) after 12 months and the survival rate was 98.2% (168 cases). The incidence of PHG before treatment was 35.5%, after 3 months of treatment, the incidence was 38.1%, with no significant difference compared with before treatment (P> 0.05); 6 months and 1 year after treatment, the incidence rates were 48.0% and 84.2%, respectively, which were significantly different from those before treatment (P <0.05). Conclusion: Treatment of gastric varices can significantly reduce the mortality rate of acute bleeding and extend the survival time. The incidence of PHG after the adhesive treatment will be significantly increased, the need to take a variety of combination therapy to reduce the incidence of PHG and improve the quality of life of patients with PHG and survival.