标题：超声内镜引导下组织胶治疗胃底静脉曲张破裂出血疗效观察

      作者：胡华华，刘俊，关丽愉，许捷鸿，易宏，李中专，覃树芬，邓翔宇    广西医科大学附属第四医院(柳州市工人医院)消化内科，广西 柳州 545000

      卷次： 2020年31卷6期

      【摘要】 目的 观察超声内镜引导下组织胶治疗胃底静脉曲张破裂出血的效果。方法 选择广西医科大学附属第四医院(柳州市工人医院) 2018年1月至2019年6月间收治的78例因肝硬化合并胃底静脉曲张破裂出血的患者，在知情同意的原则下，按随机数表法分成观察组和对照组，每组39例。对照组采用普通内镜下组织胶治疗，观察组采用超声引导的内镜下组织胶治疗法，比较两组患者的止血效果、再出血和并发症发生率。结果 观察组患者的24 h、48 h、72 h止血有效率分别为82.05%、84.62%、97.44%，明显高于对照组的41.03%、69.23%、89.74%，差异均有统计学意义(P<0.05)；随访3个月时，观察组患者的再出血发生率为12.82%，明显低于B组的20.51%，差异有统计学意义(P<0.05)；但两组患者3个月内的并发症发生率比较差异无统计学意义(P>0.05)。结论 超声引导下行内镜下组织胶治疗胃底静脉曲张破裂出血能取得更好的止血效果，再出血发生率低，但不减少并发症的发生，临床上使用的同时应重视止血后患者的生存质量，减少并发症的发生。
      【关键词】 胃底静脉；出血；组织胶；内镜；超声；疗效
      【中图分类号】 R573 【文献标识码】 A 【文章编号】 1003—6350（2020）06—0724—04

Effectiveness of endoscopic ultrasound-guided tissue adhesive in the treatment of gastric varices bleeding.
HUHua-hua, LIU Jun, GUAN Li-yu, XU Jie-hong, YI Hong, LI Zhong-zhuan, TAN Shu-fen, DENG Xiang-yu. Department ofGastroenterology, the Fourth Affiliated Hospital of Guangxi Medical University (Workers Hospital of Liuzhou City), Liuzhou545000, Guangxi, CHINA
【Abstract】 Objective To observe the effect of tissue adhesive under the guidance of endoscopic ultrasonogra-phy in the treatment of gastric varices bleeding. Methods From January 2018 to June 2019, 78 patients with liver cir-rhosis and bleeding due to rupture of gastric varices were selected from the Fourth Affiliated Hospital of Guangxi Medi-cal University (Liuzhou Workers Hospital). Under the principle of informed consent, the patients were divided into theobservation group and control group according to random number table method, with 39 cases in each group. The con-trol group was treated with ordinary endoscopic tissue adhesive, and the observation group was treated with endoscopicultrasound-guided tissue adhesive. The hemostasis effect, rebleeding rate and complication rate of the two groups were ob-served and compared. Results The effective rates of hemostasis in 24, 48 and 72 hours in the observation group were82.05%, 84.62%, 97.44%, respectively, which were significantly higher than corresponding 41.03%, 69.23%, 89.74% inthe control group (all P<0.05); after 3 months of follow-up, the incidence of rebleeding in the observation group was12.82%, which was significantly lower than 20.51% in the control group (P<0.05); however, there was no significant dif-ference in the incidence of complications within 3 months between the two groups (P>0.05). Conclusion Endoscopicultrasound-guided tissue adhesive can achieve better hemostasis effect in the treatment of gastric varices bleeding. Theincidence of rebleeding is low, but it does not reduce the incidence of complications. In clinical use, we should pay atten-tion to the quality of life of patients after hemostasis and reduce the incidence of complications.
      【Key words】 Gastric fundus vein; Hemorrhage; Tissue adhesive; Endoscopy; Ultrasound; Effectiveness