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目的:观察多环与单环套扎在肝硬化食管静脉曲张(EV)出血急诊内镜治疗后临床疗效的异同。方法:75例急诊内镜诊断为EV或合并胃底静脉曲张上消化道出血患者随机采用多环或单环橡皮圈套扎治疗,分为多环套扎治疗组和单环套扎治疗组。多环套扎治疗组40例,根据EV程度给予单位点2环、3环或4环套扎治疗;单环套扎治疗组35例。合并胃底静脉曲张须先给予硬化剂聚桂醇+组织胶+硬化剂方法注射治疗。单环套扎治疗再出血患者改用多环套扎治疗。结果:多环套扎治疗组治疗后胃镜复查EV完全消失8例,基本消失26例,EV消失率85%;单环套扎治疗组治疗后胃镜复查EV完全消失5例,基本消失15例,EV消失率57%;2组比较存在显著性差异(P<0.05)。1年再出血率多环套扎治疗组为5%,明显低于单环套扎治疗组的23%(P<0.05)。改用多环套扎治疗的再出血患者曲张静脉明显消失。结论:多环套扎治疗EV效果优于单环套扎治疗。
Objective: To observe the similarities and differences of clinical curative effect of endoscopic multi-ring and single-ring ligation in the treatment of cirrhosis esophageal varices (ED) after emergency treatment. Methods: Seventy-five patients diagnosed by EV or combined upper gastrointestinal bleeding from gastric varices were randomized to receive multi-ring or single-loop rubber band ligation. They were divided into multi-ring ligation group and single-ring ligation group. Forty cases were treated with multi-ring ligation, and were given 2, 3 or 4 ring ligation according to the degree of EV. 35 cases were treated with single ring ligation. Gastric varices should be given sclerotherapy lauryl alcohol + tissue glue + sclerotherapy method of injection therapy. Single ring ligation treatment of patients with rebleeding switched to multi-ring ligation. Results: In the multi-ring ligation group, 8 cases of EV disappeared after gastroscopy, 26 cases disappeared, 85% of EV disappeared. In the single-ring ligation group, 5 cases disappeared after gastroscopy, disappeared in 15 cases, EV disappearance rate of 57%; There were significant differences between the two groups (P <0.05). The rate of rebleeding at 1 year was 5% in the multi-ring ligation group, which was significantly lower than that in the single ring ligation group (23%, P <0.05). Switching to multi-ring ligation of patients with rebleeding varicose vein was significantly disappeared. Conclusions: Multi-ring ligation is superior to single ring ligation in the treatment of EV.