内镜下硬化剂和套扎治疗食管静脉曲张术后对门脉高压性胃病和胃底静脉曲张的影响

目的:探讨食管静脉曲张(EV)采用内镜下套扎术(EVL)和硬化剂(EVS)治疗对患者近远期并发胃底静脉曲张(GV)以及门脉高压性胃病(PHG)并发症的影响。方法:抽选我院肝硬化上消化道出血后接受内镜下治疗的患者97例为研究对象,其中19例予以内镜下EVS治疗,78例行内镜下EVL治疗,随访1年,观察治疗3个月、6个月、1年后并发GV、PHG的近远期概率。结果:治疗3个月后,本组患者GV、PHG等并发症的发生率为17.5%(17/97)、39.2%(38/97),与治疗前比较差异无显著性(P0.05);治疗6个月后,本组患者GV、PHG等并发症的发生率为32%(31/97)、70.1%(68/97),与治疗前相比,并发人数显著增加(P0.05);治疗1年后,GV、PHG的发生率为42.3%(41/97)、88.7%(86/97),并发人数显著高于治疗前(P0.05)。结论:内镜下EVS、EVL治疗在消退食管曲张静脉和良好地控制出血的同时,还可增加PHG、GV的并发几率,值得临床重视预防。

The Impact on Portal Hypertensive Gastropathy and Gastroesophageal Varices about Endoscopic Sclerotherapy and Ligation in the Treatment of Esophageal Varices

ABSTRACT Objective:To explore the impact of portal hypertensive gastropathy and gastroesophageal varices about endoscopic sclerotherapy and ligation in the treatment of esophageal varices. Methods:97 patients with bleeding after endoscopic treatment with liver cirrhosis upper gastrointestinal were chosen, among whom 19 cases were undergone endoscopic EVS treatment, 78 cases were undergone endoscopic treatment of EVL, 1 years of follow-up. 3 months, 6 months and 1 year later, the probability of occurring in patients with GV and PHG was observed. Results:After 3 months of treatment, the incidence of complications such as GV and PHG was 17.5%(17/97) and 39.2%(38/97) respectively, compared with those before treatment, there was no significant difference (P>0.05); After 6 months of treatment, the incidence of complications was 32%(31/97) and 70.1% (68/97), compared with before treatment, there was a significant increase in the number (P<0.05); After 1 year of treatment, GV, PHG rate was 42.3%(41/97) and 88.7%(86/97) respectively, concurrent number was significantly higher than that of before treatment (P<0.05).Conclusion: Endoscopic EVS, EVL treatment can not only control esophageal varices bleeding, but also can increase the probability of concurrent PHG, GV, is worth the clinical prevention.