CAJ | 학술논문

目的：观察肝硬化食管静脉曲张破裂出血患者行内镜下套扎、硬化剂及组织胶注射治疗后食管静脉曲张程度、红色征及门静脉高压性胃病的变化。方法回顾性分析本院2011年9月－2013年9月收治的75例食管静脉曲张破裂出血患者，行首次内镜下套扎、硬化剂或组织胶注射治疗。2～4周后复查胃镜，对比治疗前后曲张食管静脉的数目与直径、红色征及门静脉高压性胃病在内镜下的改变。组内治疗前后的比较采用配对t检验，率的比较采用卡方检验。结果治疗后曲张食管静脉的数目及直径均小于治疗前[（3．08±0．96）vs （3．75±0．60），t＝5．26，P＜0．05；（1．05±0．46）cm vs （1．49±0．26）cm，t＝9．84，P＜0．05）]，差异均有统计学意义。红色征的发生率较治疗前降低，差异有统计学意义（26．67％ vs 57．33％，χ2＝14．48，P＜0．05）。治疗后门静脉高压性胃病虽有所好转，但差异无统计学意义（70．67％ vs 72．00％，χ2＝0．03，P＞0．05）。结论内镜下套扎、硬化剂及组织胶注射治疗食管静脉曲张破裂出血的方法安全、有效。
목적：관찰간경화식관정맥곡장파렬출혈환자행내경하투찰、경화제급조직효주사치료후식관정맥곡장정도、홍색정급문정맥고압성위병적변화。방법회고성분석본원2011년9월－2013년9월수치적75례식관정맥곡장파렬출혈환자，행수차내경하투찰、경화제혹조직효주사치료。2～4주후복사위경，대비치료전후곡장식관정맥적수목여직경、홍색정급문정맥고압성위병재내경하적개변。조내치료전후적비교채용배대t검험，솔적비교채용잡방검험。결과치료후곡장식관정맥적수목급직경균소우치료전[（3．08±0．96）vs （3．75±0．60），t＝5．26，P＜0．05；（1．05±0．46）cm vs （1．49±0．26）cm，t＝9．84，P＜0．05）]，차이균유통계학의의。홍색정적발생솔교치료전강저，차이유통계학의의（26．67％ vs 57．33％，χ2＝14．48，P＜0．05）。치료후문정맥고압성위병수유소호전，단차이무통계학의의（70．67％ vs 72．00％，χ2＝0．03，P＞0．05）。결론내경하투찰、경화제급조직효주사치료식관정맥곡장파렬출혈적방법안전、유효。
Objective To observe the changes in degree of varices,red signs,and portal hypertensive gastropathy in liver cirrhosis patients with esophageal variceal bleeding (EVB)after endoscopic variceal ligation (EVL),endoscopic injection sclerotherapy (EIS),and tissue adhesive injection (TAI).Methods A retrospective analysis was performed on 75 patients with EVB,who were initially treated with EVL, EIS,or TAI in our hospital from September 2011 to September 2013.At 2-4 weeks after operation,gastroscopy was performed to evaluate the changes in the number and diameter of varices,red signs,and portal hypertensive gastropathy.Within-group comparison was made by paired t test,and comparison of rates was made by chi-square test.Results The number and diameter of varices decreased significantly after endoscopic therapy (3.08 ±0.96 vs 3.75 ±0.60,t=5.26,P<0.05;1.05 ±0.46 cm vs 1.49 ±0.26 cm,t=9.84,P<0.05). The rate of red signs also decreased significantly after operation (26.67%vs 57.33%,χ2 =14.48,P<0.05).However,the rate of portal hypertensive gastropathy decreased nonsignificantly after treatment (70.67%vs 72.00%,χ2 =0.03,P>0.05).Conclusion EVL,EIS, and TAI are effective and safe in liver cirrhosis patients with EVB.