【摘要】 目的探讨内镜下肝硬化食管静脉曲张套扎治疗术(EVL)疗效的影响因素。方法总结1995-06～2005-06 165例肝硬化患者行EVL治疗的资料,分析肝硬化无脾切除加断流术史者113例与有脾切除加断流术史者52例行EVL术后近期及远期疗效,并观察各种相关因素对EVL疗效的影响。结果EVL治疗后食管静脉曲张总消失率为88．48%,食管静脉曲张复发率27．27%。与无脾切除加断流术史者比较,肝硬化有脾切除加断流术史者食管静脉曲张复发率低(P＜0．01),EVL术前肝功能状态越差,食管静脉曲张复发、EVB再发率越高(P＜0．01),生存率越低(P＜0．05);EV复发组门静脉内径和脾静脉内径较非复发组宽(P＜0．01)。EVL术后服用哌唑嗪可降低门静脉压力,降低食管静脉曲张复发、EVB再发率,提高生存率(P＜0．01)。结论EVL是治疗EVB安全有效的方法,近期及远期疗效确切,EVL术后服用哌唑嗪可降低门静脉压力,降低食管静脉曲张复发、EVB再发率。更多还原

【Abstract】 Objective To study the influencing factor of curative effect of endoscopic variceal ligation(EVL).Methods The records of 165 patients treated with EVL from June 1995 and June 2005 were collected.The patients were divided into liver cirrhosis without splenectomy+devascularization op- eration group(group A)and liver cirrhosis with splenectomy+devascutarization operation group(group B).The curative effect of EVL of two groups in the short term and tong term were compared and the corre- lated factors influenced an the final outcomes were observed.Results Total disappear rate of esophageal varices was 88.48%,and the recurrence of esophageal varices was 22.27%.Compared with group A,the recurrence rate of esophageal varices was lower in group B,there was statistical significance(P＜0.01). The recurrence rate of esophageal varices bleeding(EVB)was higher(P＜0.01),and survival rate was lower(P＜0.05),when the hepatic function was worse before ligation.In patients with the esophageal varices recurrence,portal vein diameter and spleen vein diameter were widened.Prazosin can decrease the pressure of portal vein and the recurrence rate of EVB and increase survival rate after ligation(P＜0.01). Conclusion EVL,an effective and safe measure should be the first choice in treating EVB,curative effect was affirmed in short term and long term.Prazosin can decrease the pressure of portal vein and the recurrence rate of EVB and increase survival rate after ligation(P＜0.01).更多还原