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目的 对内镜曲张静脉套扎 (EVL)联合部分脾栓塞 (PSE)治疗肝硬变食管静脉曲张出血的疗效进行评价。方法 6 1例肝硬变食管静脉曲张出血并脾功能亢进患者 ,35例采用EVL联合PSE治疗 ,2 6例单用EVL治疗 ,比较两组近、远期静脉曲张根治率及再出血率。结果 ①EVL联合PSE组近期静脉曲张根治率及再出血率分别为 97.14 %、2 .86 % ,远期则分别为 76 .4 7%、5 .88% ;②EVL联合PSE治疗组远期静脉曲张根治率显著高于EVL组 (P <0 .0 1) ,再出血率低于EVL组 (P <0 .0 5 ) ,近期两者无显著性差异 (P >0 .0 5 )。结论 EVL联合PSE治疗肝硬变食管静脉曲张出血并脾功能亢进安全有效 ,近期、远期都有较高的食管静脉曲张根治率及较低的再出血率 ,远期疗效优于EVL ,值得推广。
Objective To evaluate the efficacy of endoscopic varicose vein ligation (EVL) combined with partial splenic embolization (PSE) in the treatment of hepatic cirrhosis esophageal variceal bleeding. Methods Sixteen patients with cirrhosis esophageal variceal bleeding and hypersplenism were enrolled. 35 patients were treated with EVL combined with PSE, and 26 patients were treated with EVL alone. The curative rates of radical varicocele and re-bleeding were compared between the two groups. Results ①The cure rate and recurrence rate of varicose veins in EVL group and PSE group were 97.14% and 2.86% respectively, 76.74% and 5.88% respectively in long-term; ②EVL combined PSE group The rate of rebleeding was lower than that of EVL group (P <0.05). There was no significant difference between the two groups (P> 0.05). Conclusion EVL combined with PSE is safe and effective in the treatment of hepatic cirrhosis with esophageal variceal bleeding and hypersplenism. Both EVL and PSE have a higher cure rate of esophageal varices and a lower rate of rebleeding in the short and long term, which is superior to EVL in long-term efficacy and worthy of promotion .