三腔二囊管辅助急诊内镜治疗食管胃底静脉曲张破裂出血的临床效果
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摘要
目的探讨三腔二囊管辅助急诊内镜治疗食管胃底静脉曲张破裂出血的临床效果。方法选择我院2016年10月至2018年11月收治的72例食管胃底静脉曲张破裂出血患者作为研究对象,按治疗方法的不同将其分为观察组和对照组,各36例。观察组采用三腔二囊管辅助急诊内镜进行止血治疗,对照组仅采用急诊内镜进行止血治疗。比较两组的止血效果、临床疗效、住院时间、住院费用及并发症发生情况。结果治疗后30、60、90、300 min,观察组的止血患者占比均高于对照组(P<0.05)。观察组的治疗总有效率显著高于对照组(P<0.05)。观察组住院时间显著短于对照组,住院费用及术后并发症总发生率显著低于对照组(P<0.05)。结论三腔二囊管辅助急诊内镜治疗食管胃底静脉曲张破裂出血的止血效果确切,患者并发症发生率低,住院时间及花费少,可在临床上予以推广实施。
Objective To explore the clinical effect of emergency endoscopy assisted by triple-lumen and two-capsule catheter in the treatment of ruptured esophageal and gastric varices bleeding. Methods Seventy-two patients with ruptured esophageal and gastric varices bleeding admitted in our hospital from October 2016 to November 2018 were selected as the research objects and divided into observation group and control group according to different treatment methods, with 36 cases in each group. The observation group was treated with emergency endoscopy assisted by triple-lumen and two-capsule catheter, while the control group was treated with emergency endoscopy only. The hemostatic effect, clinical efficacy, hospitalization time, hospitalization expenses and complications were compared between the two groups. Results At 30, 60, 90 and 300 min after treatment, the proportions of hemostatic patients of the observation group were higher than those of the control group(P<0.05). The total effective rate of treatment in the observation group was significantly higher than that in the control group(P <0.05). The hospitalization time of the observation group was significantly shorter than that of the control group, and the hospitalization expenses and total incidence of postoperative complications were significantly lower than those in the control group(P <0.05). Conclusion Emergency endoscopy assisted by triple-lumen and two-capsule catheter has definite hemostasis effect for ruptured esophageal and gastric varices bleeding, with low incidence of complications, less hospitalization time and expenses. It can be popularized and implemented in clinic.
Objective To explore the clinical effect of emergency endoscopy assisted by triple-lumen and two-capsule catheter in the treatment of ruptured esophageal and gastric varices bleeding. Methods Seventy-two patients with ruptured esophageal and gastric varices bleeding admitted in our hospital from October 2016 to November 2018 were selected as the research objects and divided into observation group and control group according to different treatment methods, with 36 cases in each group. The observation group was treated with emergency endoscopy assisted by triple-lumen and two-capsule catheter, while the control group was treated with emergency endoscopy only. The hemostatic effect, clinical efficacy, hospitalization time, hospitalization expenses and complications were compared between the two groups. Results At 30, 60, 90 and 300 min after treatment, the proportions of hemostatic patients of the observation group were higher than those of the control group(P<0.05). The total effective rate of treatment in the observation group was significantly higher than that in the control group(P <0.05). The hospitalization time of the observation group was significantly shorter than that of the control group, and the hospitalization expenses and total incidence of postoperative complications were significantly lower than those in the control group(P <0.05). Conclusion Emergency endoscopy assisted by triple-lumen and two-capsule catheter has definite hemostasis effect for ruptured esophageal and gastric varices bleeding, with low incidence of complications, less hospitalization time and expenses. It can be popularized and implemented in clinic.
引文
[1]孙鑫,宋明全.食管胃底静脉曲张破裂出血内镜下治疗进展[J].世界华人消化杂志,2018,26(26):1562-1566.
[2]姚飞,万荣,李凯,等.三腔二囊管辅助急诊内镜下治疗食管胃底静脉曲张破裂出血的临床研究[J].中国内镜杂志,2016,8(22):57-60.
[3]周光文,杨连粤.肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2015)[J].中国实用外科杂志,2015,10(23):1086-1090.
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[5]RIBEIRO JP,MATUGUMA SE,CHENG S,et al.Results of treatment of esophageal variceal hemorrhage with endoscopic injection of nbutyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis[J].Endosc Int Open,2015,3(6):E584-E589.
[6]朱庆曦,田霞,刘蒙,等.内镜下套扎联合组织胶注射治疗食管静脉曲张破裂出血的临床疗效[J].世界华人消化杂志,2016,24(13):2045-2050.
[7]朱磊.内镜下套扎联合硬化剂及组织胶注射治疗食管静脉曲张破裂出血患者的临床评价[J].中国民康医学,2015,27(18):60-61.
[8]WEI XQ,GU HY,WU ZE,et al.Endoscopic variceal ligation caused massive bleeding due to laceration of an esophageal varicose vein with tissue glue emboli[J].World J Gastroenterol,2014,20(42):15937-15940.
[9]文海,张太坤,陈文忠.内镜下组织胶注射联合套扎术治疗肝硬化食管胃底静脉曲张破裂出血的临床价值[J].中国医学前沿杂志:电子版,2017,9(5):111-114.
[10]蒋波涛,徐丽,李荣华,等.内镜下治疗食管和胃静脉曲张出血的疗效及门静脉血流动力学改变的临床研究[J].中华消化病与影像杂志:电子版,2015,5(2)23-27.
[11]徐春波,张鹏,曹亮.内镜下三种方法治疗食管胃底静脉曲张破裂出血效果比较[J].交通医学,2015,29(4):368-370.
[2]姚飞,万荣,李凯,等.三腔二囊管辅助急诊内镜下治疗食管胃底静脉曲张破裂出血的临床研究[J].中国内镜杂志,2016,8(22):57-60.
[3]周光文,杨连粤.肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2015)[J].中国实用外科杂志,2015,10(23):1086-1090.
[4]柯达,吴振华.内镜下硬化剂注射治疗食管胃底静脉曲张破裂出血的临床效果[J].中国病案,2018,5(16):100-102.
[5]RIBEIRO JP,MATUGUMA SE,CHENG S,et al.Results of treatment of esophageal variceal hemorrhage with endoscopic injection of nbutyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis[J].Endosc Int Open,2015,3(6):E584-E589.
[6]朱庆曦,田霞,刘蒙,等.内镜下套扎联合组织胶注射治疗食管静脉曲张破裂出血的临床疗效[J].世界华人消化杂志,2016,24(13):2045-2050.
[7]朱磊.内镜下套扎联合硬化剂及组织胶注射治疗食管静脉曲张破裂出血患者的临床评价[J].中国民康医学,2015,27(18):60-61.
[8]WEI XQ,GU HY,WU ZE,et al.Endoscopic variceal ligation caused massive bleeding due to laceration of an esophageal varicose vein with tissue glue emboli[J].World J Gastroenterol,2014,20(42):15937-15940.
[9]文海,张太坤,陈文忠.内镜下组织胶注射联合套扎术治疗肝硬化食管胃底静脉曲张破裂出血的临床价值[J].中国医学前沿杂志:电子版,2017,9(5):111-114.
[10]蒋波涛,徐丽,李荣华,等.内镜下治疗食管和胃静脉曲张出血的疗效及门静脉血流动力学改变的临床研究[J].中华消化病与影像杂志:电子版,2015,5(2)23-27.
[11]徐春波,张鹏,曹亮.内镜下三种方法治疗食管胃底静脉曲张破裂出血效果比较[J].交通医学,2015,29(4):368-370.