三种预防肝硬化食管胃静脉曲张再出血方法的对比研究

肝脏 ›› 2020, Vol. 25 ›› Issue (10): 1110-1113.

三种预防肝硬化食管胃静脉曲张再出血方法的对比研究

林雪燕, 林志辉

350005 福州福建省立医院消化科

收稿日期:2019-10-21 出版日期:2020-10-31 发布日期:2020-12-18

Received:2019-10-21 Online:2020-10-31 Published:2020-12-18

摘要/Abstract

摘要： 目的比较药物联合内镜、经颈静脉肝内门体分流术(TIPS)与外科手术预防肝硬化食管胃静脉曲张再出血的效果。方法收集2013年1月-2016年1月收住我院的肝硬化EGVB患者资料101例,根据治疗方式分为内镜组38例、介入组32例和外科组31例,内镜组给予非选择性β阻滞剂(NSBB)联合内镜下硬化剂治疗,介入组给予TIPS治疗,外科组给予贲门周围血管离断+脾切除术;比较三组治疗效果、并发症、远期生存率情况。结果治疗效果:内镜组早期再出血率26.32%明显高于介入组6.25%及外科组9.68%(P<0.05);三组在远期再出血率及静脉曲张消失率上无明显差异(P>0.05)。并发症:介入组肝性脑病发生率15.63%高于内镜组2.63%及外科组3.23%(P<0.05);内镜组新发腹水率(10.53%)及溃疡发生率(44.74%)均高于介入组(0%,0%)及外科组(3.23%,0%)(P<0.05)。三组的远期生存率无明显差异(P>0.05)。结论药物联合内镜治疗、TIPS与外科手术治疗均能有效预防食管胃静脉曲张再出血,TIPS与外科手术治疗近期疗效优于药物联合内镜治疗,但在远期疗效方面三者无明显差异。

关键词: 食管胃静脉曲张再出血, 药物联合内镜, TIPS, 外科手术

林雪燕, 林志辉. 三种预防肝硬化食管胃静脉曲张再出血方法的对比研究[J]. 肝脏, 2020, 25(10): 1110-1113.

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