内镜曲张静脉套扎联合脾栓塞治疗食管静脉曲张出血

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。

Evaluation of therapeutic efficacy of endoscopic ligation of varices combined with partial splenic embolization in treating esophageal varices bleeding

Objective To evaluate the therapeutic efficacy of endoscopic varices ligation(EVL) combined with partial splenic embolization(PSE) in the treatment of patients with liver cirrhosis complicated with esophageal varices bleeding. Methods In 61 patients with liver cirrhosis complicated with esophageal varices bleeding and hypersplenism, 35 cases were treated with EVL, combined with PSE(EVL-PSE group), and 26 cases were treated with EVL(EVL group). Short-term and long-term eradication rate and rebleeding rate of esophageal varices were compared in 2 groups. Methods In the EVL PSE group, short-term eradication and rebleeding rates of esophageal varices were 97.14% and 2.86% respectively. Long-term eradication and rebleeding rates were 76.4% and 5.88% respectively. Long-term eradication rate of esophageal varices in the EVL-PSE group was significantly higher than in the EVL group( P<0.01) and long-term rebleeding rate was lower than in the EVL group(P>0.05), but there were no significant differences between short-term eradication and rebleeding rates of esophageal varices in the EVL-PSE group and the EVL group(P<0.05). Conclusion The treatment with EVL combined with PSE in patients with liver cirrhosis complicated with esophageal varices bleeding and hypersplenism is safe and effective, which has higher short-term and long-term eradication rate and lower rebleeding rate, and long-term therapeutic efficacy is superior to EVL, worth spreading.