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目的:比较内镜下食管静脉曲张硬化治疗(EVS)、EVS+EVS加套扎(EVL)续贯EVS和EVL续贯EVS治疗食管静脉曲张的疗效.方法:乙型病毒性肝炎肝硬化食管静脉曲张破裂出血患者130例,随机分为EVS治疗组50例,EVS+EVL续贯EVS组40例,EVL续贯EVS组40例,比较3组食管静脉曲张的消失率、并发症、硬化剂总用量,患者住院天数和远期复发出血率.结果:三组患者治疗后食管静脉曲张消失率无差异;EVS组硬化剂应用总量、治疗次数和住院天数都高于EVS+EVL续贯EVS组,EVL续贯EVS组(95.64±37.51 mL vs 55.90±38.93 mL,32.15±26.97 mL;3.64±1.32 vs 1.85±1.18,1.35±0.88;25.92±8.69 vs 20.6±5.00 d,17.55±4.62 d;P均<0.05),而后两组之间没有差异;EVL续贯EVS组食管静脉曲张复发率高于另外两组(45% vs 12%,20%,P<0.05),而后两组间没有差异.3组间再出血发生率及并发症的发生率没有差别.结论:EVL续贯EVS和EVS+EVL续贯EVS在食管静脉曲张的治疗上优于单纯EVS,尤其后者兼具EVL和EVS的优点.
Objective: To compare the efficacy of endoscopic esophageal variceal sclerosis (EVS) and EVS plus EVS plus ligation (EVL) for EVS and EVL EVS in the treatment of esophageal varices.Methods: Hepatitis B cirrhosis esophageal vein One hundred and thirty patients with variceal bleeding were randomly divided into EVS treatment group (n = 50), EVS + EVL sequential EVS group (n = 40) and EVL sequential EVS group (n = 40). The incidence of esophageal varices disappeared, complications, Dosage, hospital stay days and long-term recurrence hemorrhage rate.Results: There was no difference in the disappearance rate of esophageal varices among the three groups after treatment, and the total amount of curatives, the number of treatments and hospital stay in EVS group were higher than those in EVS + EVL group , EVL group (95.64 ± 37.51 mL vs 55.90 ± 38.93 mL, 32.15 ± 26.97 mL; 3.64 ± 1.32 vs 1.85 ± 1.18, 1.35 ± 0.88; 25.92 ± 8.69 vs 20.6 ± 5.00 d, 17.55 ± 4.62 d respectively; P <0.05), while there was no difference between the two groups. The recurrence rate of esophageal varices in the EVL group was higher than that in the other two groups (45% vs 12%, 20%, P <0.05), but there was no difference between the latter two groups.3 There was no difference in the incidence of rebleeding and the incidence of complications between the two groups.Conclusion: EVL and EVS + EVL EVS are superior in the treatment of esophageal varices EVS pure, and in particular, which combines the advantages of the EVS EVL.