目的观察内镜下密集套扎和非密集套扎治疗重度食管静脉曲张患者的疗效。方法将60例肝硬化并发食管静脉重度曲张患者分为两组，32例（A组）采用密集套扎，28例（B组）采用非密集套扎。两组均采用6连发套扎器行内镜下治疗。以一次使用套扎圈<6个为非密集套扎，>6个为密集套扎。结果在A组32例患者中，套扎1次者7例，2次者20例，3次者5例，平均套扎1.9次。首次平均每例患者结扎12个点。在首次套扎1月后复查胃镜发现，食管静脉曲张治愈、有效和无效者分别为6例（18.8%）、24例（75.0%）和2例（6.3%）。1例患者在术后5个月因肝肾综合征而死亡；在B组28例患者中，套扎1次者1例，2次者8例，3次者16例，4次者3例，平均套扎2.8次。首次每例患者结扎6个点。首次套扎1月后复查胃镜发现食管静脉曲张治愈、有效和无效者分别为1例（3.6%）、24例（85.7%）和3例（10.7%）。1例患者在术后10天因消化道大出血而死亡。两组疗效比较，无显著性差异（P>0.05）。结论采用内镜下套扎法治疗食管静脉曲张有效，但如何操作使治疗更有效还需要进一步观察。%Objective To observe the efficacy of two ways of endoscopic variceal ligation in the treatment of patients with esophagus and gastric varices bleeding. Methods 60 cirrhotic patients with severe esophageal varices were divided into two groups receiving dense ligation (group A included 32 patients) and non-dense liga-tion (group B included 28 patients). Six shooter multi-band ligators were used under endoscopy. More than six collar of loop ligature was used as dense ligation and less than or equal to six collar of loop ligature as non-dense ligation. Results In group A,7 had one,20 had two,5 had three with average of 1.9 ligation and each patient had 12 points at first time. One month after first ligature,6 patients were basically cured,24 patients were greatly improved,2 patients did not respond to the treatment; In group B,1 had one,8 had two,16 had three, and 3 had four with average of 2.8 ligation and each patient had 6 points at first time. One month after first lig-ature,1 patients were basically cured,24 patients were greatly improved,3 patients did not respond to the treat-ment. Conclusion Dense ligation is a safe,reliable and effective approach to esophageal varices,which eradicates esophageal varices effectively.
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