目的 探讨内镜下组织胶注射联合套扎术治疗肝硬化食管胃底静脉曲张破裂出血的临床价值.方法 选择本院2012年8月至2016年7月收治的170例重度肝硬化食管胃底静脉曲张破裂出血患者为研究对象.采用随机数表法将其分为A组(组织胶注射联合硬化剂,80例)和B组(组织胶注射联合套扎术,90例).随访6个月,分析并比较两组患者近期再出血率、远期再出血率、并发症发生率、死亡率、临床疗效及胃底静脉曲张疗效.结果 B组患者远期再出血率、并发症发生率及死亡率均显著低于A组(P<0.05),治疗总有效率和胃底静脉曲张总有效率均显著高于A组(P<0.05).结论 内镜下组织胶注射联合套扎术治疗肝硬化食管胃底静脉曲张破裂出血疗效显著,可以有效降低并发症发生率和死亡率.%Objective To investigate the clinical value of endoscopic tissue adhesive injection combined with variceal ligation in the treatment of esophageal-gastric varices bleeding in patients with liver cirrhosis. Method 170 cases of patients with severe liver cirrhosis with esophageal-gastric varices bleeding in our hospital from August 2012 to July 2016 were selected as the subjects. They were divided into group A (tissue adhesive injection combined with sclerosis agent, 80 cases) and group B (tissue adhesive injection combined with ligation, 90 cases) according to the random number table method. The followed-up time was 6 months. The general effect of the two groups were analyzed and compared, included recent rebleeding rate, long-term rebleeding rate, complication rate and mortality. The difference of clinical efficacy and efficacy of gastric fundus varicose veins were compared. Result The long-term rebleeding rate, complication rate and mortality rate of group B were significantly lower than that of group A (P < 0.05), the total efficiency of treatment and the total effective rate of varices veins of group B were significantly higher than that of group A (P < 0.05). Conclusion Endoscopic tissue adhesive injection combined with variceal ligation is effective in the treatment of liver cirrhosis with esophageal-gastric varices bleeding, and can reduce the rate of complications mortality and effectively.
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