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目的评价粘合剂α-氰基丙烯酸烷基酯联合硬化剂乙氧硬化醇治疗瘤状孤立性1型胃静脉曲张(IGV1)出血的临床疗效。方法对16例瘤状IGV1出血患者进行内镜下α-氰基丙烯酸烷基酯联用乙氧硬化醇注射治疗,观察临床止血疗效、胃静脉曲张消除情况及临床不良反应。结果全组16例患者粘合剂和硬化剂平均注射次数为(1.56±0.51)次,α-氰基丙烯酸烷基酯每例平均注射(1.36±0.20)ml,乙氧硬化醇每例平均注射(7.13±2.96)ml,即时止血率100%。术后平均随访(244.44±90.51)d内,再出血率18.75%,无死亡病例。内镜随访胃静脉曲张消退显著有效6例(42.86%),有效6例(42.86%),无效2例(14.28%),总有效率为85.72%。结论内镜下粘合剂α-氰基丙烯酸烷基酯联合乙氧硬化醇治疗控制瘤状IGV1出血迅速有效,并有望消除胃静脉曲张。
Objective To evaluate the clinical efficacy of adhesive agent α-cyanoacrylate combined with hardener ethoxylated alcohol in the treatment of hemorrhage of isolated solitary gastric varices type 1 (IGV1). Methods 16 cases of patients with IGV1 hemorrhage were treated with endocervical injection of α-cyanoacrylic acid alkyl ester and ethoxylated alcohol to observe the curative effect of hemostasis, elimination of gastric varices and clinical adverse reactions. Results The mean injection times of adhesive and sclerosant in all 16 patients were (1.56 ± 0.51) times, and the average injection of alkyl α-cyanoacrylate was (1.36 ± 0.20) ml in each group. The mean injection of ethoxylated alcohol (7.13 ± 2.96) ml, immediate hemostasis rate of 100%. After an average follow-up (244.44 ± 90.51) d, the rate of rebleeding was 18.75%, with no deaths. Endoscopic follow-up of gastric varices was significantly effective in 6 cases (42.86%), effective in 6 cases (42.86%), 2 cases (14.28%), the total effective rate was 85.72%. Conclusion Endoscopic treatment with alkyl α-cyanoacrylate and ethoxylated alcohol is effective in controlling the bleeding of tumorous IGV1 and is expected to eliminate gastric varices.