心得安联合内镜套扎术预防食管静脉曲张再出血的疗效分析

目的比较心得安联合内镜套扎治疗与单独内镜套扎治疗预防食管静脉曲张再出血的疗效。方法 65例食管静脉曲张破裂出血的患者随机分为心得安联合内镜套扎治疗组(33例),单独内镜套扎治疗组(32例),平均随访12个月,比较两组间再出血率,门脉高压性胃病,食管静脉曲张复发和胃底静脉曲张的发生率。结果两组治疗后随访第6,12个月显示,与单独内镜套扎治疗比较,心得安联合内镜套扎治疗显著降低再出血率(15.2%vs 37.5%,21.2%vs 46.9%,P<0.05),门脉高压性胃病(18.2%vs43.8%,30.3%vs 56.3%,P<0.05),食管静脉曲张复发(15.2%vs 37.5%,24.2%vs 50.0%,P<0.05)和胃底静脉曲张的发生率(12.1%vs 34.4%,21.2%vs 46.9%,P<0.05)。结论心得安联合内镜套扎治疗是二级预防食管静脉曲张出血的首选治疗方法。     

内镜下密集套扎法治疗食管静脉曲张破裂出血的效果观察

目的观察内镜下密集套扎法治疗食管静脉曲张破裂出血的临床疗效。方法选取石家庄市第五医院2015年7月-2016年6月因肝硬化门静脉高压食管静脉曲张破裂出血首次行内镜下套扎治疗的156例患者的临床资料,根据治疗方法不同分为密集套扎组(n=76)和非密集套扎组(n=80)。对患者随访观察1~2年,统计患者的静脉曲张根除或基本消失率、套扎次数、早期再出血率、迟发性再出血率及不良反应发生率等。计量资料2组间比较采用t检验;计数资料2组间比较采用χ~2检验或Fisher精确检验。结果密集套扎组与非密集套扎组静脉曲张根除或基本消失率(71.05%vs 55.00%)、套扎次数比较,差异均有统计学意义(χ~2值分别为4.300、8.511,P值分别为0.038、0.014),2组患者早期再出血率(5.26%vs 2.50%)、迟发性再出血率(7.89%vs10.00%)、静脉曲张复发率(13.16%vs 18.75%)及不良反应发生率(26.32%vs 21.25%)比较,差异均无统计学意义(P值均0.05);静脉曲张复发时间比较,差异有统计学意义[(11.90±1.89)个月vs(7.07±1.17)个月,t=2.295,P=0.031]。随访期间,156例患者中共死亡2例(1.28%),其中密集套扎组和非密集套扎组各死亡1例。2组病死率比较,差异无统计学意义(P0.05)。结论内镜下密集套扎法治疗食管静脉曲张破裂出血较安全,静脉曲张消失率及套扎次数优于非密集套扎法,静脉曲张复发晚。     

组织胶联合套扎术治疗食管胃底静脉曲张破裂出血的随访研究

目的探讨α-氰基丙烯酸正丁酯医用粘合剂联合内镜下食管静脉套扎术治疗食管胃底静脉曲张破裂出血的临床价值。方法选取2016年9月-2018年1月我院94例食管胃底静脉曲张破裂出血患者,按照随机数字表法分为观察组与对照组,每组47例。对照组给予单纯内镜下食管静脉套扎术治疗,观察组给予α-氰基丙烯酸正丁酯医用粘合剂联合内镜下食管静脉套扎术治疗。对比两组止血成功率、术后早期(术后7 d内)再出血发生率、静脉曲张治疗效果、术后并发症发生率,随访至术后6个月,对比两组复发率、手术前及术后6个月生活质量(SF-36)评分。结果 (1)止血疗效:观察组止血成功率97.87%(46/47)与对照组95.74%(45/47)比较无显著差异(P0.05);术后早期再出血率4.26%(2/47)低于对照组17.02%(8/47,P0.05);(2)静脉曲张治疗效果:观察组静脉曲张治疗总有效率93.62%(44/47)高于对照组78.72%(37/47,P 0.05);(3)并发症:观察组并发症发生率29.79%(14/47)与对照组25.53%(12/47)比较无显著差异(P0.05);(4)复发率:术后6个月,观察组复发率4.26%(2/47)与对照组12.77%(6/47)比较无显著差异(P0.05);(5)生活质量:手术前两组SF-36生理功能、社会功能、健康状况、情感职能各维度评分比较无显著差异(P0.05),术后6个月观察组SF-36各维度评分高于对照组(P0.05)。结论α-氰基丙烯酸正丁酯医用粘合剂联合内镜下食管静脉套扎术治疗食管胃底静脉曲张破裂出血,效果显著,可有效降低术后早期再出血发生率,且不会增加治疗相关并发症发生风险,因研究选取样本量少尚无有效数据证实其可降低疾病复发率,且对改善患者生活质量具有一定积极作用。     

内镜套扎术联合药物预防食管静脉曲张破裂出血的观察

目的 探讨内镜套扎术联合药物预防食管静脉曲张破裂出血的有效性.方法 将64例肝硬化伴食管静脉曲张破裂出血患者随机分为治疗组33例(内镜套扎术+普萘洛尔+单硝酸异山梨醇酯)和对照组31例(普萘洛尔+单硝酸异山梨醇酯)分别进行治疗,对比两组治疗前后内镜下食管静脉曲张变化、血液动力学监测结果和再出血率等情况.结果 治疗后两组Dpv、Dsv、Qpv、Qsv与治疗前比较均显著下降(P<0.05),Vpv、Vsv治疗前后比较,差异无统计学意义,两组血液动力学监测对比,差异无统计学意义(P>0.05);6个月时治疗组有3例(9%)、对照组有6例(19.4%)再次发生出血,两组再出血率差异有统计学极显著意义(P<0.01),12个月时治疗组共有4例(12.1%)对照组共有11例(35.5%)再次发生上消化道出血,两组再出血率差异仍有统计学极显著意义(P<0.01);64例进行胃镜复查,治疗组6个月时食管静脉曲张轻度或消失为51.5%(17/33),12个月时为48.5%(16/33),对照组6个月和12个月均为3.2%(1/31),由中度变为轻度.结论 内镜套扎术联合药物预防食管静脉曲张破裂出血效果优于单纯药物治疗,且安全、效果明显,病人易接受,可作为预防食管静脉曲张破裂出血的首选方法.     

内镜下食管静脉结扎术治疗食管静脉曲张破裂出血67例分析

目的探讨内镜下食管静脉结扎术（EVL）治疗食管静脉曲张破裂出血的临床效果。方法对67例食管静脉曲张破裂出血患者行EVL,随访5～18个月。结果完全根除率为73.2%,部分根除率为26.8%;随访18个月,静脉曲张复发率为44.8%,复发时间为术后5～8个月;再出血率和病死率分别为23.88%和25.37%。结论食管静脉曲张结扎术是一种治疗食管静脉曲张破裂出血的有效方法;但复发率较高,需进一步改善远期疗效。     

内镜治疗后口服卡维地洛预防肝硬化食管静脉曲张破裂出血患者再出血的效果分析

[目的]探讨内镜套扎术治疗后口服卡维地洛预防肝硬化食管静脉曲张破裂出血患者再出血的效果。[方法]选取我院2013年1月~2014年12月收治的肝硬化食管静脉曲张破裂出血患者72例。根据入院诊治时间顺序,将72例患者交替分为对照组及观察组,每组患者36例。2组患者行内镜下套扎术后,对照组患者口服普萘洛尔进行治疗,观察组口服卡维地洛进行治疗。比较2组患者临床疗效及不良反应情况。[结果]观察组患者平均随访时间20.2个月,对照组平均随访时间20.0个月,观察组患者平均每天口服药物剂量为(17.36±5.69)mg,对照组患者平均每天口服药物剂量为(95.36±18.63)mg,观察组患者每天口服药物剂量明显低于对照组(P0.05);观察组患者总出血率明显低于对照组(2.77%vs.16.66%)(P0.05);观察组食管静脉曲张改善程度明显优于对照组(P0.05);在服药依从性比较方面,观察组自行停药率低于对照组(2.77%vs.19.44%),差异有统计学意义(P0.05);2组患者在治疗过程中以胸痛、发热、头晕、心动过缓为主要不良反应,观察组不良反应总发生率明显低于对照组(19.44%vs.52.77%),差异有统计学意义(P0.05)。[结论]内镜治疗后口服卡维地洛预防肝硬化食管静脉曲张破裂出血患者再出血临床疗效显著,安全性高,值得临床推广。     

“U型”反转套扎技术在食管胃静脉曲张治疗中的应用

目的评价“U型”反转套扎技术治疗食管胃静脉曲张的疗效。方法将191例食管胃静脉曲张患者随机分为2组：内镜下常规套扎（EVL）组101例行内镜下常规套扎;内镜下反转套扎（EVLR）组90例先行反转镜环周套扎贲门下曲张静脉,而后常规套扎食管。观察术后18个月内曲张静脉治疗效果、平均治疗次数、急诊止血率、近期再出血率及静脉曲张复发率等。结果随访期内,治疗后显效率、无效率,平均治疗次数,2组差异均有统计学意义（P均〈0．05）,EVLR组明显优于EVL组,且EVLR组急诊止血率可达100％。但近期再出血率、静脉曲张复发率、并发症发生率、病死率与EVL组相比,差异均无统计学意义（P均〉0．05）。结论经反转镜贲门下环周套扎法可以提高食管胃静脉曲张破裂急诊止血率,较常规套扎显效率高,治疗次数少,安全性高。     

硬化剂和套扎治疗食管胃底静脉曲张破裂出血34例临床观察

目的对比分析硬化剂注射术和套扎术治疗食管胃底静脉曲张破裂出血的临床疗效。方法收集在西京医院进修学习期间2014年8月至2015年2月期间经硬化剂注射术治疗的34例食管胃底静脉曲张破裂出血患者设为观察组,另选同期的34例经套扎术治疗的食管胃底静脉曲张破裂出血患者设为对照组,观察两组患者的止血成功率、并发症发生率及病死率。结果观察组和对照组在止血成功率和病死率方面比较差异无统计学意义(P0.05),而观察组并发症发生率明显低于对照组(P0.05)。结论硬化剂注射术和套扎术治疗食管胃底静脉曲张破裂出血均具有良好的临床疗效,而采用硬化剂注射术更能减少并发症发生。     

康复新预防肝硬化食管静脉曲张套扎术后患者早期再出血效果分析

目的探讨康复新预防肝硬化食管静脉曲张套扎术(EVL)后患者早期再出血的效果。方法选取我院收治的132例行肝硬化食管静脉曲张套扎术治疗的患者作为研究对象,采用随机数字表法分为两组,每组66例。对照组患者术后进行常规预防早期再出血治疗;观察组在此基础上加用康复新治疗,疗程2周。比较两组患者早期再出血情况、套扎局部溃疡愈合情况及不良反应发生情况。结果术后14 d,观察组患者发生再出血2例(3.03%),对照组患者发生再出血8例(12.12%),两组术后早期再出血率比较差异具有统计学意义(P0.05)。EVL术后行胃镜复查,观察组患者套扎点溃疡面治疗总有效为95.35%,对照组为88.72%,观察组患者溃疡面愈合情况显著优于对照组(P0.05)。观察组患者恶心发生率显著高于对照组(P0.05)。结论康复新能有效促进肝硬化食管静脉曲张套扎术后患者溃疡面愈合,降低再出血的发生率。     

内镜下套扎联合经皮经肝TH胶栓塞治疗肝硬化食管胃底静脉曲张的临床应用

目的评价内镜下套扎(EVL)联合经皮经肝曲张静脉TH胶栓塞术(PTVE)治疗肝硬化食管胃底静脉曲张出血的远期疗效。方法 44例肝硬化食管胃底静脉曲张出血患者,先行食管曲张静脉的内镜下套扎治疗,1周后再行TH胶PTVE,栓塞食管胃底曲张静脉区域及其来源血管。联合治疗术后定期复查胃镜,观察曲张静脉消失情况,随访治疗后曲张静脉复发率及再出血率。结果 44例食管胃底静脉曲张患者,32例食管曲张静脉基本消失,消失率72.7%;8例胃底静脉曲张基本消失,消失率100%;12例食管静脉曲张程度明显减轻,总有效率100%。随访6~39个月,平均25.6个月,5例食管静脉曲张复发,复发率11.4%;3例再出血,再出血率6.8%。结论内镜下套扎治疗能机械性地消除食管曲张静脉,经皮经肝TH胶栓塞能栓塞食管胃底曲张静脉区域及其供血血管,二者联合能达到协同作用,具有更好的远期疗效。     

Esophageal variceal ligation for acute variceal bleeding: results of three years' follow-up.

BACKGROUND/AIMS: Endoscopic variceal ligation is widely accepted as the optimum endoscopic treatment for esophageal variceal hemorrhage. However, the rebleeding course and long-term outcome of patients with esophageal variceal hemorrhage after ligation have been poorly defined. Therefore, we conducted a long-term follow-up study to delineate the outcome of ligation. METHODS: Twenty-one liver cirrhotic patients with endoscopically proven esophageal variceal hemorrhage were treated by endoscopic variceal ligation. These patients received regular follow-up and detailed clinical assessment of at least 24 months. RESULTS: Twenty-one eligible patients were followed up for a mean of 44.45 months (range 33.5-64 months). The mean number of sessions required to obtain eradication was 3.57+/-1.99 (range 1-8). Esophageal varices could be obliterated within 11.57+/-6.8 weeks (range 3-30). The percentage of variceal recurrence during follow-up was 57.14% (12/21) after endoscopic variceal ligation. Recurrence were observed in a mean of 34 months (median 29 months). Rebleeding from esophageal varices appeared in four patients (19.04%). The appearance rates of portal hypertensive gastropathy and fundal gastric varices after varice obliteration were found to be 45.45% (5/11) and 25% (3/12), respectively. CONCLUSIONS: Based on the results of long-term follow-up of endoscopic variceal ligation, although the percentage of variceal recurrence was high, endoscopic ligation achieved variceal obliteration faster and in fewer treatment sessions. Furthermore, endoscopic variceal ligation had a lower rate of rebleeding and of development of fundal gastric varices, but high portal hypertensive gastropathy.     

Argon plasma coagulation prevents variceal recurrence after band ligation of esophageal varices: preliminary results of a prospective randomized trial

BACKGROUND: Endoscopic variceal ligation is an established procedure for eradication of esophageal varices. However, varices frequently recur after endoscopic variceal ligation. Argon plasma coagulation has been used as supplemental treatment for eradication of varices and for prevention of variceal recurrence in small uncontrolled series. The aim of this study was to determine whether argon plasma coagulation is effective in reducing variceal recurrence after endoscopic variceal ligation. METHODS: Thirty patients with cirrhosis, a history of acute esophageal variceal bleeding, and eradication of varices by endoscopic variceal ligation were randomized to argon plasma coagulation (16 patients) or observation (14 patients). The 2 groups were similar with respect to all background variables including age, Child-Pugh score, presence of gastric varices, and degree of portal hypertensive gastropathy. In the argon plasma coagulation group, the entire esophageal mucosa 4 to 5 cm proximal to the esophagogastric junction was thermocoagulated circumferentially with argon plasma coagulation in 1 to 3 sessions performed at weekly intervals. Endoscopy was performed every 3 months to check for recurrence of varices in both groups. RESULTS: During the course of the study, no serious complication was noted. After argon plasma coagulation, transient fever occurred in 13 patients and 8 complained of dysphagia or retrosternal pain/discomfort. Mean follow-up for all patients was 16 months (range 9-28 months). No recurrence of varices or variceal hemorrhage was observed in the argon plasma coagulation group, whereas varices recurred in 42.8% (6/14) of the patients in the control group (p < 0.04) and bleeding recurred in 7.2% (1/14). CONCLUSIONS: Argon plasma coagulation of the distal esophageal mucosa after eradication of esophageal varices by endoscopic variceal ligation is safe and effective for reducing the rate of variceal recurrence.     

内镜套扎术在治疗食管静脉曲张破裂出血中的临床应用价值

目的探讨内镜下食管静脉曲张套扎术（EVL）治疗和预防肝硬化患者食管静脉曲张破裂出血的临床应用价值。方法回顾性分析2008-01～2012-01该院142例肝硬化食管静脉曲张破裂出血患者,其中行EVL治疗74例（治疗组）,内科保守治疗68例（对照组）,并对其临床疗效进行随访观察。结果所有患者随访6个月以上,治疗组的早期再出血率、迟发出血率、曲张静脉好转率、复发率、手术率及病死率均低于对照组（P〈0.05或〈0.01）。结论 EVL能有效地降低肝硬化门脉高压患者食管静脉曲张的程度,降低再出血率、复发率、手术率和病死率,是一种有效的内镜治疗手段。     

内镜套扎联合硬化剂夹心法治疗食管静脉曲张破裂出血的远期疗效观察

[目的]探讨内镜下静脉曲张套扎同时应用硬化剂夹心法(套扎-硬化-套扎即EVL-EVS-EVL)治疗食管静脉曲张破裂出血的疗效。[方法]对23例肝硬化食管静脉曲张破裂出血的患者采用夹心法治疗,每条曲张静脉结扎皮圈不超过3个,并在2个结扎点之间的曲张静脉内注射l~3ml硬化剂。其中10例在首次内镜治疗时接受食管静脉造影检查。于治疗后2周、1个月、3个月、6个月、12个月胃镜随访,了解静脉曲张变化情况,记录患者不良反应及并发症。[结果]10例行静脉造影检查中7例硬化剂在曲张静脉内滞留时间超过40min。夹心法控制活动性食管静脉曲张出血的止血成功率为100%,静脉曲张消除率为86.9%(20/23),再出血发生率为8.6%(2/23),随访期内静脉曲张复发率为13.0%(3/23)。[结论]夹心法能使硬化剂在曲张静脉内滞留较长时间,在一次治疗后能有效提高静脉曲张消除率,降低再出血率及静脉曲张复发率,是内镜下治疗食管静脉曲张破裂出血的较理想选择。     

小剂量硬化剂加固对食管静脉曲张术后的影响

目的探讨在密集套扎疗法的基础上进行硬化加固治疗对于食管静脉曲张复发的防治作用。方法对食管静脉曲张套扎治疗后食管曲张静脉消失或基本消失的患者进行硬化剂加固治疗,从齿状线开始依次向上在残存小曲张静脉内与血管旁粘膜下层注射5％鱼肝油酸钠,每点注射1—2ml,每次共注射10—14ml。观察其对静脉曲张消失后复发的预防作用。结果加固治疗组49例共行硬化治疗132次,平均2．7次,最多治疗4次。随访12～25个月,平均18个月。结果40例（81．9％）患者未发现食管静脉曲张再出现,原有细小静脉明显减轻或消失,9例复发。加固组与单纯套扎组再出血率有明显差异（10．2％对23．4％,P〈0．05）;超声内镜检查显示加固治疗组食管曲张静脉发现率明显低于单纯套扎组（42．9％对76．6％,P〈0．01）;加固治疗组与单纯套扎组穿通支血管检出率无明显差异（42．8％对57．4％,P〉0．05）。治疗后未发现严重并发症。结论套扎治疗后小剂量硬化剂加固治疗可显著减少套扎术后残留的食管曲张静脉、防止闭塞消失的静脉再通、预防再出血,有助于提高结扎术的长期疗效,延缓静脉曲张的复发。     

内镜根除治疗食管静脉曲张后复发的相关因素分析

目的：探讨食管静脉曲张（EV）经内镜下套扎序贯硬化（EVLS）根除治疗后影响复发的因素。方法对61例食管静脉曲张患者行 EVLS 治疗达到根除标准后随访2年,依据复发时间分为高危组（24月内复发）与低危组（24月内未复发）,收集食管静脉曲张经内镜治疗达到根除标准时患者的生化及随访期间的临床资料进行统计学分析。结果2年内食管静脉曲张复发24例（39.3％）,未复发37例（60.7％）;高危组与低危组在出血、脾功能亢进、糖尿病和中/重度腹水的发生率以及 Child-Pugh 评分、血清白蛋白、血小板计数、凝血酶原时间和超声测量门静脉直径等方面差异有统计学意义（P 均＜0.05）;进一步行非条件 Logistic 回归分析显示出血史、中/重度腹水和糖尿病病史（OR 值分别为9.7,6.5和10.8）是食管静脉曲张复发的独立危险因素。结论出血、中/重度腹水、糖尿病是食管静脉曲张复发的独立危险因素,对该类患者应积极随访和再治疗。     

内镜下套扎治疗晚期血吸虫病食道静脉曲张破裂出血68例

目的 探讨内镜下套扎治疗晚期血吸虫病食道静脉曲张破裂出血的效果。方法 130例晚期血吸虫病食道静脉曲张破裂出血住院患者随机分成2组,治疗组68例接受急诊内镜下套扎治疗,对照组62例给予常规内科治疗。观察各组继续出血率及静脉曲张红色征消失情况等,并进行比较。结果 治疗组继续出血率为10.3%,静脉曲张红色征阳性率为8.8%,均优于对照组,差异有统计学意义（P均＜0.01）。结论 内镜下套扎治疗是晚期血吸虫病食道静脉曲张破裂出血的一种有效止血方法。     

A new "sandwich" method of combined endoscopic variceal ligation and sclerotherapy versus ligation alone in the treatment of esophageal variceal bleeding: a randomized trial

BACKGROUND: Variceal ligation is the optimum endoscopic method for treating esophageal variceal bleeding. However, both early and multiple recurrences of esophageal varices frequently follow ligation. The aim of this randomized study was to determine whether a new, combined endoscopic "sandwich" method (i.e., ligation-sclerotherapy-ligation) could achieve better results than ligation alone. METHODS: Ninety-four patients with cirrhosis and acute or recent esophageal variceal bleeding were randomized to undergo either the "sandwich" method or ligation alone (47 patients in each group). RESULTS: The sclerosant was retained in the varices for more than 30 minutes in 7 of 8 patients undergoing the "sandwich" method plus radiographic contrast medium. Active bleeding was controlled with this new method (9/9) as efficiently as ligation (12/12). The rate of recurrent bleeding was similar for both methods. Multivariate analysis showed the necessity for the use of antibiotics (odds ratio 3.95: 95% CI [1.60, 9.76]) to be an independent factor for recurrent bleeding. Two patients in the "sandwich" group developed strictures, but the frequency of other complications did not differ between the 2 groups. Kaplan-Meier analysis showed the cumulative probability of variceal recurrence was lower with the "sandwich" method (p = 0.0391). The survival rate and causes of death were similar in both groups. CONCLUSIONS: The "sandwich" method leads to longer retention of sclerosant in varices. This method is superior to ligation alone in terms of lower variceal recurrence rate and comparable to ligation with respect to hemostasis. However, it is unknown whether the lower recurrence rate of varices will persist long-term.     

Prevention of variceal recurrence, bleeding, and death in cirrhosis patients with hypersplenism, especially those with severe thrombocytopenia

BACKGROUND/AIMS: We investigated the impact of different treatments on the prognosis of cirrhosis patients with esophageal varices and thrombocytopenia. METHODOLOGY: This prospective study enrolled 52 cirrhosis patients with esophageal varices and hypersplenism (platelet count < 50,000/mm3). In 26 patients, endoscopic variceal ligation plus partial splenic embolization were performed, while endoscopic variceal ligation alone was done in 26 patients. Endoscopic variceal ligation was repeated until complete eradication of varices was achieved. Partial splenic embolization was performed using the Seldinger method and embolic material was injected until a 60% to 80% reduction of splenic blood flow was achieved. The primary endpoints during the follow-up period included recurrence of varices, variceal bleeding, and death. RESULTS: Comparison of endoscopic variceal ligation plus partial splenic embolization with endoscopic variceal ligation alone by multivariate analysis showed a relative risk ratio of 0.390 (95% CI [0.178-0.854]; p = 0.024) for new varices, 0.191 (95% CI [0.047-0.780]; p = 0.021) for variceal bleeding, and 0.193 (95% CI [0.053-0.699]; p = 0.012) for death. CONCLUSIONS: These results suggest that endoscopic variceal ligation plus partial splenic embolization can prevent variceal recurrence, bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia.     

经内镜栓塞术联合套扎术治疗食管胃底静脉曲张出血的疗效观察

目的探讨胃底静脉曲张栓塞术联合内镜下食管静脉曲张套扎术（EVL）治疗肝硬化上消化道出血的疗效。方法经急诊胃镜检查发现活动性胃底静脉曲张出血合并Ⅱ°以上食管静脉曲张且排除其他病因的上消化道出血患者共156例,分为治疗组和对照组,治疗组胃底静脉曲张组织粘合剂栓塞同时食管静脉EVL治疗;对照组胃底静脉曲张组织粘合剂栓塞治疗2个月后行食管静脉EVL。结果两组均未发生与治疗相关的并发症。止血成功率治疗组为96．3％（77／80）,对照组为97．4％（74／76）,（P〉0．05）;近期再出血率治疗组为6．4％（5／78）,对照组为21．3％（16／75）,两组差异有统计学意义（P〈0．05）;两组患者随访6个月,再出血率分别为13．0％（9／69）、25．4％（17／67）,差异有统计学性意义（P〈0．05）。胃底静脉曲张改善总有效率治疗组和对照组分别为61．6％、59．1％,食管曲张静脉改善总有效率为74．0％、67．9％,差异均无统计学意义。结论胃底静脉曲张栓塞联合EVL是治疗肝硬化胃底静脉曲张出血并食管静脉曲张的安全有效方法,同时联合治疗更能降低再出血率。