内镜下两种套扎法治疗食管静脉重度曲张疗效观察

目的观察内镜密集套扎和非密集套扎治疗重度食管静脉曲张的疗效。方法选取2009年1月-2011年10月住院的肝硬化并食管静脉重度曲张患者60例，分为两组：A组为密集套扎组32例，B组为非密集套扎组（标准组）28例。采用6连发套扎器行内镜治疗。分组标准以一次使用套扎圈≤6个为非密集套扎组，〉6个为密集套扎组。结果A组首次结扎1个月后复查：食管静脉曲张基本治愈（曲张静脉基本消除）者6例，静脉曲张程度减轻者24例，无效2例，总有效率93．8％，平均结扎次数1．94次。B组首次套扎1个月后复查：食管静脉曲张基本治愈（曲张静脉基本消除）者1例，有效者有24例，无效者3例（其中死亡1例），总有效率89．3％，平均结扎次数2．75次。结论食管静脉曲张采用密集套扎法连续治疗，静脉曲张消失率高，能减少套扎次数，是一种有效治疗食管静脉重度曲张的可靠方法。

Efficacy of Two Methods in Treating Severe Esophageal Varices with Endoscopic Variceal Ligation

Objective To observe the efficacy of dense ligation and non-dense ligation in treating severe esophageal varices. Methods Sixty cirrhotic patients with severe esophageal varices treated in our hospital between January 2009 and October 2011 were divided into two groups based on their operative ways. Group A was the dense ligation group including 32 patients, and group B was non-dense ligati0n group in which there were 28 patients. Six-shooter multi-band ligators were used for endoscopy. If the number of loop ligature collar was larger than six, it was regarded as dense ligation and the rest was regarded as non-dense ligation. Results In group A, one month after first ligature, six patients were basically cured, 24 were greatly improved, and two did not respond to the treatment, with a total effective rate of 93.8% and an average ligation of 1.94 times. In group B, one month after first ligature, one patient was basically cured, 24 were greatly improved, and three did not respond to the treatment, with a total effective rate of 89.3% and an average ligation of 2.75 times. Conclusion Dense ligation is a safe, reliable and effective approach for esophageal varices, which brings about a high disappearance rate of esophageal varices and reduced ligation frequency.