【摘要】 目的探讨急诊内镜治疗肝硬化食管胃底静脉曲张出血(EGVB)的最佳治疗方案。方法EGVB患者960例,随机分为3个治疗组,即单纯套扎(EVL)组328例,单纯硬化(EVS)组322例,套扎+硬化(EVL+EVS)组310例;以止血成功率(ARH)及再出血率(RR)评价疗效。结果EVL+EVS组的ARH(98.7%,306/310)显著高于EVL组(94.8%,311/328)及EVS组(94.1%,303/322)(χ2=9.70,P<0.01);EVL+EVS组的RR(9.7%,30/310)与EVL组(15.9%,52/328)及EVS组(15.5%,50/322)比较差异无统计学意义(χ2=6.42,P>0.05)。结论EVL+EVS治疗肝硬化EGVB能显著提高急诊止血成功率,减少了内镜治疗次数及硬化剂用量,为目前急诊内镜治疗EGVB较为安全有效的方法。更多还原

【Abstract】 Objective To investigate the best emergent endoscopic therapy for esophageal and gastric variceal bleeding(EGVB).Methods Nine hundred and sixty patients with esophageal and gastric variceal bleeding were randomly assigned to three groups: endoscopic variceal ligation(EVL) group(n=328),endoscopic variceal sclerotherapy(EVS) group(n=322) and EVL+EVS group(n=310).The therapeutic effects of three groups were evaluated by achievement ratio of hemostasis(ARH) and ratio of rehaemorrhagia(RR).Results ARH of EVL+EVS group(98.7%,306/310)was remarkably higher than that of EVL group(94.8%,311/328) and EVS group(94.1%,303/322)(χ~2=9.70,P<0.01).RR of EVL+EVS group(9.7%,30/310) showed no significant difference with that of EVL group(15.9%,52/328)and EVS group(15.5%,50/322)(χ~2=6.42,P>0.05).Conclusion Emergent EVL+EVS for esophageal and gastric variceal bleeding can remarkably improve ARH.This combinant therapy cuts down the frequency of endoscopic therapy and sclerosant dosage.It is a safe and effective therapy for esophageal and gastric variceal bleeding at present.更多还原