[1]边 芬,张国梁,羊 丹.内镜下聚桂醇联合组织胶改良注射与传统注射治疗2型胃食管静脉曲张的疗效对比[J].天津医科大学学报,2016,22(02):133-137.
BIAN Fen,ZHANG Guo-liang,YANG Dan.Comparison of efficacy of endoscopic lauromacrogol combined with tissue adhesive by modified sandwich injection method and conventinal injection in the treatment of type 2 gastroesophageal varices[J].Journal of Tianjin Medical University,2016,22(02):133-137.
点击复制
内镜下聚桂醇联合组织胶改良注射与传统注射治疗2型胃食管静脉曲张的疗效对比(PDF)
BIAN Fen,ZHANG Guo-liang,YANG Dan.Comparison of efficacy of endoscopic lauromacrogol combined with tissue adhesive by modified sandwich injection method and conventinal injection in the treatment of type 2 gastroesophageal varices[J].Journal of Tianjin Medical University,2016,22(02):133-137.
《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]
- 卷:
- 22卷
- 期数:
- 2016年02期
- 页码:
- 133-137
- 栏目:
- 临床医学
- 出版日期:
- 2016-03-20
文章信息/Info
- Title:
- Comparison of efficacy of endoscopic lauromacrogol combined with tissue adhesive by modified sandwich injection method and conventinal injection in the treatment of type 2 gastroesophageal varices
- 文章编号:
- 1006-8147（2016）02-0133-05
- Author(s):
- BIAN Fen1; ZHANG Guo-liang2; YANG Dan1
- （1.Department of Gastroenterology , The First Central Clinical College , Tianjin Medical University , Tianjin 300192 , China；2.Department of Gastroenterology , The First Central Hospital of Tianjin , Tianjin 300192 ,China）
- Keywords:
- gastroesophageal varices; tissue adhesive; lauromacrogol; lipiodol; endoscopic tissue adhesive obturation
- 分类号:
- R57
- DOI:
- -
- 文献标志码:
- A
- 摘要:
- 目的：评价内镜下聚桂醇联合组织胶改良三明治注射治疗2型胃食管静脉曲张（GOV2）的临床疗效。方法：对照组为传统组织胶三明治治疗(碘油-组织胶-碘油)，共 53例；改良组为聚桂醇联合组织胶改良三明治治疗（聚桂醇-组织胶-聚桂醇），共92例，比较两组止血成功率、胃静脉曲张改善情况、再出血率、并发症发生率。结果：两组术后平均随访时间分别为（15.13±7.5）月、（14.75±7.31）月，两组止血成功率均为100 %，术后静脉消失率分别为18.9%、34.8%，有效率分别为43.4%、43.5%，总体有效率分别为62.3%、78.3%，再出血率分别为39.6%、33.7%，其中总体有效率和静脉消失率差别有统计学意义，并且静脉发生消失与缓解时间有明显差异 (P<0.05)。对照组术后出现1例肺栓塞，改良组未出现异位栓塞，两组并发症比较无明显差异。结论：内镜下聚桂醇联合组织胶改良三明治治疗GOV2的疗效优于传统组织胶注射治疗。
- Abstract:
- Objective ：To assess the clinical effect of endoscopic lauromacrogol combined with tissue adhesive by modified sandwich injection on the treatment of type 2 gastroesophageal varices（GOV2）. Methods：A retrospective study was performed to review the clinical and follow up data of 145 patients with GOV2 bleeding who had initially received tissue adhesive injection. The control group of 53 cases was treated with the traditional sandwich method (lipiodol- tissue adhesive- lipiodol) , while the modified group including 92 cases was treated with the modified sandwich method (lauromacrogol -tissue adhesive- lauromacrogol). Then we compared the hemostatic rate, improvement of gastric varices , rebleeding rate and incidence of complications between two groups. Results：The average follow-up time for two groups were (15.13 ± 7.5) months and (14.75 ± 7.31) months respectively. The hemostatic rates of two groups were both 100%, the eradication rate of gastric varices were 18.9%, 34.8% respectively, the effective rates were 43.4% and 43.5% respectively , the total effective rates were 62.3% and 78.3% respectively, and the rebleeding rates were 39.6% and 33.7% respectively. The differences in the total effective rate and the eradication rate between two groups were statistically significant, and the time to eradicate and remit varices also had showed significant differences (P < 0.05). One patient in control group had pulmonary embolism while no one had distant embolisms in modified group. No difference between two groups in complications were found. Conclusion：For the treatment of GOV2, endoscopic lauromacrogol combined with tissue adhesive is more effective than traditional tissue adhesive.
参考文献/References:
[1]Kim T, Shijo H, Kokawa H, et al. Risk factors for hemorrhage from gastric fundal varices[J].Hepatology,1997,25(2):307 [2]Kumar A, Singh S, Madan K, et al. Undiluted N-butyl cyanoacrylate is safe and effective for gastric variceal bleeding[J].Gastrointest Endosc,2010,72(4):721 [3]Kim Y D. Management of acute variceal bleeding[J].Clin Endosc, 2014,47(4):308 [4]Sarin S K, Lahoti D, Saxena S P, et al. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients[J].Hepatology,1992,16(6):1343 [5]中华医学会消化内镜学分会食管胃静脉曲张学组.消化道静脉曲张及出血的内镜诊断和治疗规范试行方案(2009年)[J].中国继续医学教育,2010,27(6):21 [6]Chang C J, Hou M C, Liao W C, et al. Management of acute gastric varices bleeding[J]. J Chin Med Assoc,2013,76(10):539 [7]Fujii-Lau L L, Law R, Wong Kee Song L M, et al. Novel techniques for gastric variceal obliteration[J].Dig Endosc,2015,27(2):189 [8]Kiyosue H, Mori H, Matsumoto S, et al. Transcatheter obliteration of gastric varices. Part 1. Anatomic classification[J]. Radiographics, 2003,23(4):911 [9]Park J K, Saab S, Kee S T, et al. Balloon-Occluded retrograde transvenous obliteration (BRTO) for treatment of gastric varices: review and Meta-Analysis[J].Dig Dis Sci,2015,60(6):1543 [10]Hong C H, Kim H J, Park J H, et al. Treatment of patients with gastric variceal hemorrhage: endoscopic N-butyl-2-cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration[J].J Gastroenterol Hepatol,2009,24(3):372 [11]Tan Y M, Goh K L, Kamarulzaman A, et al. Multiple systemic embolisms with septicemia after gastric variceal obliteration with cyanoacrylate[J].Gastrointest Endosc,2002,55(2):276 [12]Cheng L F, Wang Z Q, Li C Z, et al. Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate[J]. Clin Gastroenterol Hepatol,2010,8(9):760 [13]Jun C H, Kim K R, Yoon J H, et al. Clinical outcomes of gastric variceal obliteration using N-butyl-2-cyanoacrylate in patients with acute gastric variceal hemorrhage[J].Korean J Intern Med,2014,29(4):437 [14]Saracco G, Giordanino C, Roberto N, et al. Fatal multiple systemic embolisms after injection of cyanoacrylate in bleeding gastric varices of a patient who was noncirrhotic but with idiopathic portal hypertension[J].Gastrointest Endosc,2007,65(2):345 [15]Seewald S, Ang T L, Imazu H, et al. A standardized injection technique and regimen ensures success and safety of N-butyl-2-cyanoacrylate injection for the treatment of gastric fundal varices (with videos)[J].Gastrointest Endosc,2008,68(3):447 [16]王艳梅，程留芳，李楠，等.内镜下注射组织粘合剂治疗胃静脉曲张出血的排胶规律研究[J].中国内镜杂志,2010,16(1):9 [17]Kojima K, Imazu H, Matsumura M, et al. Sclerotherapy for gastric fundal variceal bleeding: is complete obliteration possible without cyanoacrylate?[J].J Gastroenterol Hepatol,2005,20(11):1701 [18]吴云林，吴巍. 控制胃静脉曲张出血及消除静脉瘤体的介入治疗[J].中华消化病与影像杂志:电子版,2012,2(1):4 [19]史琲，吴云林，吕婵，等.粘合剂联合硬化剂治疗瘤状孤立性1型胃静脉曲张[J].肝脏,2008,13(4):287 [20]Shi B, Wu W, Zhu H, et al.Successful endoscopic sclerotherapy for bleeding gastric varices with combined cyanoacrylate and aethoxysklerol[J].World J Gastroenterol,2008,14(22):3598 [21]刘志忠，赵燕颖，孙远杰，等.一次性注射硬化剂加组织黏合剂治疗胃底曲张静脉出血的疗效观察[J].中华消化杂志,2014,34(3):183 [22]Kahloon A, Chalasani N, Dewitt J, et al. Endoscopic therapy with 2-octyl-cyanoacrylate for the treatment of gastric varices[J].Dig Dis Sci,2014,59(9):2178
相似文献/References:
备注/Memo
- 备注/Memo:
- 作者简介 边芬（1990-），女，硕士在读，研究方向：肝病；通信作者：张国梁，E-mail：zgl_022@sina.com。
常用功能
统计/Statistics
- 摘要浏览/Viewed1268
- 全文下载/Downloads679
- 评论/Comments
