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。

Recurrence factors for esophageal varices after endoscopic eradication therapy

Objective To investigate the recurrence factors for esophageal varices after endoscopic eradication therapy of endoscopic sequential variceal ligation plus sclerotherapy （EVLS）. Methods Sixty-one patients with esophageal varices achieved eradication standards after EVLS therapy were followed up for 2 years. The patients were divided into high recurrence risk group （relapse within 24 months） and low recurrence risk group （without recurrence within 24 months） according to the recurrence time,and the biochemical and clinical data of the two groups were collected and analyzed statistically. Results There were 24 （39.3%） cases of patients diagnosed with esophageal variceal recurrence within two years,and 37（60.7%）without recurrence. There were significant differences between the two groups as respect to bleeding history,spleen hyperthyroidism,diabetes,moderate/severe ascites, Child-Push scores,serum albumin,platelet counts,prothrombin time and portal vein diameters measured by ultra-sound（P〈0.05）;Furthermore,non-conditional logistic regression analysis showed that bleeding history,moderate/severe ascites and diabetes history were independent risk factors for esophageal varices recurrence （OR value 9.7,6.5 and 10.8,respectively）. Conclusions Bleeding history,moderate/severe ascites and diabetes history are independent risk factors for esophageal varices recurrence and these patients should be actively followed up and retreated in time.