肝脏恶性肿瘤患者食管胃底曲张静脉破裂出血急诊胃镜止血疗效研究
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摘要
目的:旨在对肝恶性肿瘤合并食管胃底曲张静脉出血患者进行急诊胃镜止血治疗进行对比分析。方法:选择河北省沧州市中心医院普外内镜科2012年1月~2015年12月收治的120例肝脏恶性肿瘤患者食管胃底曲张静脉破裂出血患者为研究对象,以患者出血类型为分组依据。A组:30例,行内镜下行套扎或硬化止血;B组:30例,行内镜下行胃底组织胶注射联合套扎或硬化止血;C组:30例,行内镜下行胃底组织胶注射止血;对照组:30例,未行内镜下治疗。观察急诊胃镜治疗后止血效果,以及术后30d、90d、180d、365d生存率。结果:A、B、C三组患者于内镜下行止血治疗后,其急诊止血成功、早期再出血、近期再出血统计学分析,其结果无明显差异(P>0.05);但均明显优于对照组(P<0.05);且A、B、C三组患者术后30d、90d、180d、365d生存率比较无明显差异(P>0.05);但均明显优于对照组(P<0.05)。结论:肝恶性肿瘤合并食管胃底曲张静脉出血患者进行急诊胃镜止血治疗,具良好的安全性、高效性,并可有效降低再出血风险;同时,在全面提高患者生活质量的基础上也有效地延长了患者的生存期。
Objective:Objective to compare and analyze the emergency endoscopic hemostasis in patients with liver malignant tumor complicated with esophageal varices bleeding.Methods:120 cases of patients with esophageal varices bleeding in patients with liver cancer in our hospital from January 2012 to-2015 in were selected as the research data.A group:30 cases underwent endoscopic ligation or sclerosis hemostasis;B group:30 cases underwent endoscopic gastric tissue glue injection plus ligation or hardening hemostasis;C group:30 cases underwent endoscopic gastric tissue glue injection hemostasis;control group:30 cases received endoscopic treatment To observe the hemostatic effect and the survival rate of 30 d,90d,180 d and 365 d after emergency gastroscopy.Results;A,B,C three groups of patients in the endoscopic hemostasis after the emergency hemostasis,early rebleeding,re-bleedingshortly statistical analysis,the results showed no significant difference(P > 0.05);but were significantly better than the control group(P < 0.05);and A,B,C of three groups of patients after operation 30 d,90d,180 d and 365 d survival rate have no significant difference(P >0.05);but were significantly better than the control group(P < 0.05).Conclusion:Hepatic malignant tumor complicated with esophageal varices bleeding were treated with emergency gastroscopy hemostasis,more secure,efficient,and can effectively reduce the risk of rebleeding;at the same time,the increase in overall quality of life of patients based on effectively prolong the survival of patients.
Objective:Objective to compare and analyze the emergency endoscopic hemostasis in patients with liver malignant tumor complicated with esophageal varices bleeding.Methods:120 cases of patients with esophageal varices bleeding in patients with liver cancer in our hospital from January 2012 to-2015 in were selected as the research data.A group:30 cases underwent endoscopic ligation or sclerosis hemostasis;B group:30 cases underwent endoscopic gastric tissue glue injection plus ligation or hardening hemostasis;C group:30 cases underwent endoscopic gastric tissue glue injection hemostasis;control group:30 cases received endoscopic treatment To observe the hemostatic effect and the survival rate of 30 d,90d,180 d and 365 d after emergency gastroscopy.Results;A,B,C three groups of patients in the endoscopic hemostasis after the emergency hemostasis,early rebleeding,re-bleedingshortly statistical analysis,the results showed no significant difference(P > 0.05);but were significantly better than the control group(P < 0.05);and A,B,C of three groups of patients after operation 30 d,90d,180 d and 365 d survival rate have no significant difference(P >0.05);but were significantly better than the control group(P < 0.05).Conclusion:Hepatic malignant tumor complicated with esophageal varices bleeding were treated with emergency gastroscopy hemostasis,more secure,efficient,and can effectively reduce the risk of rebleeding;at the same time,the increase in overall quality of life of patients based on effectively prolong the survival of patients.
引文
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[9]陈世耀,陈洁.内镜治疗食管胃静脉曲张破裂出血的地位[J].实用肝脏病杂志,2013,16(3):198-200.
[10]张文辉,董政,韩军,等.478例食管胃静脉曲张出血急诊内镜治疗[J].解放军医学院学报,2013,34(7):708-710.
[2]孙自勤.食管胃静脉曲张破裂出血的内镜治疗[J].现代消化及介入诊疗,2013,18(1):27-29.
[3]卫生和计划生育委员会卫生公益性行业科研专项专家组.门脉高压症食管胃曲张静脉破裂出血治疗技术规范专家共识(2013版)[J].中华消化外科杂志,2014,13(6):401-404.
[4]王敏.食管胃底静脉曲张破裂出血急诊内镜下治疗62例应用分析[J].中国医药导刊,2013,15(10):1627-1630.
[5]李蕾蕾急诊内镜下套扎联合组织胶注射治疗食管胃底静脉曲张破裂出血的疗效分析[J].中国疗养医学,2014,23(4):324-325.
[6]晋琼玉,徐泽艳,徐静,等.内镜下套扎联合硬化术及药物治疗食管胃底静脉曲张出血的临床疗效观察[J].西部医学,2013,25(9):1365-1367.
[7]曹立军,贺学强,张清勇,等.急诊内镜下组织胶注射术联合硬化-套扎术同步序贯治疗食管胃底静脉曲张出血58例[J].世界华人消化杂志,2014,22(33):5136-5143.
[8]熊锦华,陈力强,范公忍.急诊胃镜下组织胶治疗胃底静脉曲张破裂出血的疗效观察[J].医学综述,2013,19(24):4555-4556.
[9]陈世耀,陈洁.内镜治疗食管胃静脉曲张破裂出血的地位[J].实用肝脏病杂志,2013,16(3):198-200.
[10]张文辉,董政,韩军,等.478例食管胃静脉曲张出血急诊内镜治疗[J].解放军医学院学报,2013,34(7):708-710.