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目的研究内镜下食管静脉曲张套扎术(EVL)联合组织胶栓塞术用于肝硬化食管胃底静脉曲张出血(EVB)患者中的疗效及安全性。方法对河南省人民医院2014年1月—2016年6月采用套扎术联合组织胶栓塞术的87例肝硬化食管胃底静脉曲张出血患者的临床资料进行回顾分析,观察疗效及统计并发症。结果早期再出血率3.4%,迟发性再出血率12.8%。术后3月食管静脉曲张显效为37.8%,有效为31.7%;胃底静脉曲张显效为23.2%,有效为29.3%。术后6月食管静脉曲张显效为43.3%,有效为32.1%;胃底静脉曲张显效为26.9%,有效为34.6%。术后并发症有恶心、呕吐55例(63.2%),胸痛43例(49.4%),上腹不适10例(11.5%),发热7例(8%),穿孔1例(1.1%)。结论 EVL联合组织胶栓塞术用于肝硬化食管胃底静脉曲张出血治疗安全有效,但存在一定的并发症。
Objective To study the efficacy and safety of endoscopic esophageal variceal ligation (EVL) combined with tissue plug embolization in patients with cirrhosis and esophageal varices bleeding (EVB). Methods The clinical data of 87 patients with esophageal variceal bleeding from cirrhosis who underwent ligation combined with rubber plug operation from January 2014 to June 2016 in Henan Provincial People’s Hospital were retrospectively analyzed to observe the curative effect and statistical complication. Results The rate of early rebleeding was 3.4% and the rate of delayed rebleeding was 12.8%. The incidence of esophageal varices after 3 months was 37.8%, effective rate was 31.7%. The rate of gastric varices was 23.2% and the effective rate was 29.3%. The incidence of esophageal varices was 43.3% at 6 months after surgery, with an effective rate of 32.1%. The gastric varices was effective at 26.9% and effective rate was 34.6%. Postoperative complications included nausea and vomiting in 55 cases (63.2%), chest pain in 43 cases (49.4%), upper abdominal discomfort in 10 cases (11.5%), fever in 7 cases (8%) and perforation in 1 case (1.1%). Conclusion EVL combined with plastic plug surgery for the treatment of cirrhosis esophageal varices bleeding is safe and effective, but there are some complications.