目的:观察内镜下食管胃静脉曲张精准断流术(ESVD)的疗效.方法:选取2017年1月至2017年8月钦州市第一人民医院收治的门脉高压食管胃静脉曲张破裂出血患者80例为研究对象,依照患者入院顺序将其分成两组,每组40例.对照组给予内镜下套扎术治疗,观察组在内镜下实施ESVD术,记录两组手术一般情况及食管胃静脉曲张改善情况,并对比两组治疗后6个月内再出血率及并发症发生率.结果:两组患者手术一般情况比较无显著差异(P>0.05);观察组治疗有效率为85.00%,高于对照组的55.00%(P<0.05);术后3、6个月观察组再出血率5.00%、10.00%,明显低于对照组的30.00%、40.00%(P<0.05);术后6个月与对照组相比,观察组患者并发症发生率偏低,但无显著差异(P>0.05).结论:对门脉高压食管胃静脉曲张破裂出血患者在内镜下实施ESVD术后近期疗效较好,可促进患者恢复,远期疗效有待进一步观察.%Objective To observe the therapeutic therapy of endoscopic esophageal gastric variceal devascularization (ESVD). Methods Eighty patients with portal hypertension and esophagogastric variceal bleeding treated in Qinzhou First People's Hospital from January 2017 to August 2017 were selected and then divided into observation group and control group, with 40 cases in each group. The patients in control group were given endoscopic ligation therapy, and those in observation group were treated with endoscopic ESVD. The general surgery condition and gastroesophageal varices improvements in the two groups were record. The rebleeding rate and complication rate within 6 months after treatment were compared between two groups. Results No significant differences were found between two groups in general surgery condition, including operative time, intraoperative blood loss and postoperative hospital stay (P>0.05). The effective rate in observation group was higher than that in control group (85% vs 55%, P<0.05). At 3 and 6 months after operation, the rebleeding rate was 5% and 10% in observation group, which were lower than 30% and 40% in control group (P<0.05). At 6 months after operation, the complication rate is slightly lower in observation group as compared with control group, but the differences were trivial (P>0.05). Conclusion Endoscopic ESVD for patients with portal hypertension and esophageal variceal bleeding achieves a good short-term therapeutic effect and promote the recovery, but the long-term efficacy is needed to be further observed.
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