内镜下硬化治疗与经皮经肝介入治疗的对比研究

目的探讨内镜下硬化治疗和经皮经肝食管-胃底静脉丛栓塞(介入治疗)对食管胃底静脉曲张破裂出血的疗效比较和对出血的预防作用。方法将食管-胃底静脉曲张破裂出血患者分为经皮经肝食管-胃底静脉丛栓塞组和内镜下硬化治疗两组,治疗后内镜随访1年,了解止血成功率、再出血率、有效率、内镜下食管曲张静脉消失率和不良反应率。结果介入组和内镜下硬化组止血成功率分别是87.09%(27/31)和95.35%(41/43),内镜下硬化治疗组止血成功率显著高于介入组;再出血率为35.48%(11/31)和7.69%(3/43),内镜下硬化治疗组再出血率显著低于介入组;内镜下硬化治疗组随访内镜下观察有效率、消失率显著高于药物和介入治疗组。结论内镜下食管胃底静脉曲张硬化治疗疗效和介入治疗均为治疗食管-胃底静脉曲张的有效方法,内镜下硬化治疗远期效果优于介入治疗。

Therapeutic Effects of Injection of Endoscope Stiffening Agent and Inter-ventional Embolization: A Contrast Study

Objective To investigate the therapeutic effects of injection of endoscope stiffening agent （IESA） and interventional embolization （IE） on esophageal and gastric fundus varices hemorrhage. Methods We divided the cases of esophageal and gastric fundus varices hemorrhage into two groups：IESA group and IE group. The endoscopic follow-up after treatment was carried out in the hemostasis success rate, the rebleeding rate, the effective rate, the disappearance rate of endoscopic esophageal varices hemorrhage and the adverse effects rate. Results The hemostasis success rates of the IESA group and the IE group were 95.35%（41~43）and 87.09%（27/31）,higher in the former than in the latter. The rebleeding rates of the IESA group and the IE group were 7.69%（3/43） and 35.48%（ 11/31 ）, lower in the former than in the latter.The effective rates and the disappearance rate of endoscopic esophageal varices hemorrhage of the IESA group were significantly higher than those of the IE group. Conclusion EIS and IE are the more effective in the treatment of esophageal and gastric fundus varices hemorrhage; and EIS is most effective in the prevention of the relapsed bleeding than IE.