内镜下限流栓塞术在门脉高压IGV1患者中的应用研究

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摘要目的探究内镜下限流栓塞术在门脉高压孤立性胃底静脉曲张（IGV）患者中的应用效果。方法选取2018年5月至2019年5月赣州市第五人民医院收治的50 例门脉高压IGV 患者作为研究对象，按照随机数字表法分为对照组（25 例）和观察组（25 例）。对照组采用硬化联合组织胶水栓塞治疗，观察组采用钛夹限流联合硬化+组织胶水栓塞治疗。比较两组术前及术后14 d 的门静脉血流状态（内径、流速、流量）、肝功能[丙氨酸转氨酶（ALT）、总胆红素（TBil）、谷草转氨酶（AST）]，比较两组术后14、30、90 d 内的死亡率、胃内曲张静脉消失率、并发症总发生率。结果术后14 d，两组的门静脉内径长于术前、流速快于术前、流量大于术前，且观察组的门静脉内径长于术前、流速快于术前、流量大于对照组，差异有统计学意义（P＜0.05）；术后14 d，两组的ALT、TBil、AST 均低于术前，且观察组的ALT、TBil、AST 低于对照组，差异有统计学意义（P＜0.05）。两组术后14、30、90 d 的死亡率比较，差异无统计学意义（P＞0.05）；观察组的并发症总发生率低于对照组，胃内曲张静脉消失率高于对照组，差异均有统计学意义（P＜0.05）。结论内镜下限流栓塞术在门脉高压IGV 患者治疗中的效果显著，可有效改善其门静脉血流状态以及肝功能，亦有助于减少术后并发症发生，临床应用价值较高。

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关键词 ：内镜, 限流栓塞术, 门脉高压, 孤立性胃底静脉曲张

Abstract：Objective To explore the application effect of endoscopic flow limiting embolization in patients with portal hypertension and isolated gastric varices (IGV).Methods A total of 50 patients with portal hypertension and IGV admitted to the Fifth People′s Hospital of Ganzhou between May 2018 and May 2019 were selected as the research subjects.According to the random number table method, they were divided into control group (25 cases) and observation group (25 cases).The control group was given sclerotherapy combined with tissue glue embolization, and observation group was treated with titanium clip flow restriction combined with sclerotherapy + tissue glue embolization.The portal blood flow status (diameter, flow velocity, flow volume) and liver function (alanine aminotransferase [ALT], total bilirubin [TBil], aspartate aminotransferase [AST]) of the two groups were compared before surgery and at 14 d after surgery.The mortality rate, disappearance rate of intragastric varicose veins and incidence rate of complications were compared between the two groups within 14, 30 and 90 d after surgery.Results At 14 d after surgery, the portal vein diameter of the two groups was longer than that before surgery, flow velocity was faster than that before surgery, and flow volume was higher than that before surgery, and the portal vein diameter of the observation group was longer than that of the control group, flow velocity of the observation group was faster than that of the control group, flow volume of the observation group was higher than that of the control group, the differences were statistically significant (P＜0.05).The levels of ALT, TBil, and AST in the two groups were lower than those before surgery, and the levels of observation group were lower than those of the control group, the differences were statistically significant (P＜0.05).There were no statistically significant differences in the mortality rate between the two groups within 14, 30 and 90 d after surgery (P＞0.05).The incidence rate of complications in observation group was lower than that in control group, the disappearance rate of intragastric varicose veins was higher than that in control group, the differences were statistically significant (P＜0.05).Conclusion Endoscopic flow limiting embolization has a significant effect in the treatment of patients with portal hypertension and IGV.And it can not only effectively improve the portal vein blood flow and liver function, but also help reduce the occurrence of postoperative complications and improve the quality of life of patients, with high clinical application value.

Key words： Endoscopy Flow limiting embolization Portal hypertension Isolated gastric varices

基金资助:江西省卫生计生委科技计划项目（20197411）。

引用本文:

梁斌；王冬梅；肖梅；周观林；许飞；姜曼蕾；杨智军；胡江玲 . 内镜下限流栓塞术在门脉高压IGV1患者中的应用研究[J]. 中国当代医药, 2021, 28(29): 60-63.
LIANG Bin；WANG Dong-mei； XIAO Mei；ZHOU Guan-lin；XU Fei；JIANG Man-lei1 YANG Zhi-jun1 HU Jiang-ling. Application effect of endoscopic flow limiting embolization on patients with portal hypertension complicated with isolated gastric varices. 中国当代医药, 2021, 28(29): 60-63.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I29/60

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