无痛胃镜下套扎治疗食管静脉曲张的疗效及安全性分析

目的:探讨无痛胃镜下套扎治疗食管静脉曲张的疗效与安全性。方法:25例肝硬化患者共行35例次胃镜下套扎治疗,其中行普通胃镜组(普遍组)10例次,无痛胃镜组(无痛组)25例次;观察2组患者术前、术中、术后呼吸、心率、血压、血氧饱和度,术后调查患者对胃镜下套扎治疗的耐受情况及医生对手术的满意度,以及术前和术后7 d的肝功能及凝血酶原时间的变化。结果:除普通组术中的舒张压、收缩压高于无痛组外(P<0.05),2组患者的心率、呼吸、血氧饱和度在术前、术中、术后差异均无统计学意义(P>0.05);术中操作医生对食管蠕动及视野满意度无痛组明显高于普通组(P<0.01);2组术前、术后7 d丙氨酸氨基转移酶、白蛋白、总胆红素、凝血酶原时间差异均无统计学意义(P>0.05);无痛组术后7 d丙氨酸氨基转移酶和凝血酶原时间较术前明显下降(P<0.01),普通组术后7 d丙氨酸氨基转移酶较术前明显下降(P<0.01)。结论:无痛胃镜下套扎治疗食管静脉曲张是一种安全、易被患者接受且手术医生满意度较高的治疗方法。

Efficiency and safety of endoscopic ligation by painless gastroscopy for treatment of esophageal varices

Objective：To explore the efficiency and safety of endoscopic ligation by painless gastroscopy for treatment of esophageal varices.Methods：Twenty five patients with esophageal varices due to liver cirrhosis were performed 35 endoscopic ligations,10 cases of which received ordinary gastroscopy and 25 cases painless gastroscopy.The respiration,heart rate,blood pressure and blood oxygen saturation were observed during operation;and the patients′ tolerance and the surgeon′s satisfaction to the performance were investigated after the operation.The liver function and prothrombin time were examined before and 7 days after the operation in all the patients.Results：There were no significant differences with regard to the heart rate,respiration and oxygen saturation between the two groups（P0.05）,but the diastolic pressure and systolic pressure in the ordinary gastroscopy group were higher than those in the painless gastroscopy group during the operation（P0.05）.More satisfactory operating vision was obtained in the painless gastrocopy group than in the ordinary gastroscopy group（P0.01）.There were no significant differences with regard to the alanine aminotransferase,albumin,total bilirubin and prothrombin time before and seven days after the operation between the two groups（P0.05）.The alanine aminotransferase and prothrombin time at seven days after operation were significantly lower than those before operation in the painless gastroscopy group;the alanine aminotransferase at seven days after operation was significantly lower than that before operation in the ordinary gastroscopy group.Conclusions：Endoscopic esophageal varices ligation by painless gastroscopy is safe and easy to be accepted by patients and surgeons.