目的 比较食管静脉曲张破裂出血急诊内镜下套扎与硬化治疗的疗效和安全性.方法 对210例食管静脉曲张破裂出血患者,急诊情况下行内镜下套扎或硬化治疗,并分析比较两组急诊止血成功率、近期再出血率、急诊治疗曲张静脉消失率、不良反应、并发症、病死率等情况.结果急诊止血成功率套扎组达95.4％,硬化组达96.0％；近期再出血率分别为4.8％和4.1％；套扎组急诊治疗曲张静脉消失率明显优于硬化组(P＜0.01).两组不良反应、并发症及病死率无差别.临床疗效与肝功能呈正相关.结论 急诊内镜下套扎与硬化治疗食管静脉曲张出血均为有效、安全的止血方法.临床上可结合患者实际情况综合考虑后选择.%Objective To evaluate the safety and efficiency of emergency endoscopic variceal ligation( EVL) compared with endoscopic variceal sclerotherapy( EVS) in treatment of esophageal variceal beeding(EVB) . Methods A total of 210 patients with EVB were involved in this study and were treated with emergency EVL or EVS randomly respectively. The effective rate of hemostasis,recently rebleeding rate, disappearance rate of esophageal varices, adverse reaction, complications and mortality rate was compared and analyzed between two groups. Results The effective rate of emergency hemostasis was 95. 4% in EVL group and 96. 0% in EVS group, recently rebleeding rate was 4. 8% and 4. 1% in EVL group and EVS group respectively;disappearance rate of esophageal varices in EVL group was significantly higher than that in EVS group (P <0. 01). There was no difference of adverse reaction, complications and mortality rate between the two groups. Clinical efficacy was positively correlated with liver function. Conclusion Both emergency EVL and EVS are effective and safe technique in the treatment of patients with EVB. Which method is the better for the patients with EVB depends on the condition of the patient.
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