Objective To evaluate the clinical efficacy of endoscopic variceal ligation(EVL),combined en-doscopic variceal sclerotherapy(EVS)using modified sandwich method(lauromacrogol-tissue adhesive-lauromac-rogol)in the treatment of esophageal varices bleeding(EVB).Methods A total of 99 cirrhotic patients with EVB were divided into EVL group(n=33),EVS group(n=33)and EVLS group(n=33).Patients were followed-up for 2 years,the emergency hemostatic rate,the effective rate of variceal alleviation,recent and long-term rebleed-ing rate and the incidence rate of complications were compared among three groups.Results The emergency hemo-static rate,the effective rate of variceal alleviation,recent and long-term rebleeding rate and the incidence rate of complications of EVLS group was better than those of other two groups(P<0·05),while there was no significant difference between EVL and EVS groups(P>0·05).Conclusion The endoscopic sequential variceal ligation plus sclerotherapy can ensure emergency hemostasis and reduce the recurrence and long-term rebleeding with low inci-dence of complications in treatment of esophageal varices bleeding.%目的 观察内镜套扎术联合改良三明治法注射治疗食管胃底静脉曲张出血的近远期疗效.方法选取我院99例胃底食管静脉曲张患者,通过随机数字表法分为套扎组,注射组和联合治疗组(每组各33例),套扎组单独使用内镜套扎术,注射组单独使用组织胶与聚桂醇的改良三明治法注射,联合治疗组联合使用内镜套扎术和组织胶与聚桂醇的改良三明治法注射,观察比较3组的治疗有效率、止血成功率、近期再出血和并发症,以及2年后随访情况.结果 经过治疗后,联合治疗组的治疗有效率为94%,明显高于其他2组,差异具有统计学意义(P<0·05).联合治疗组的止血成功率,近期再出血和并发症,也明显优于其他2组,差异具有统计学意义(P<0·05).在2年后的随访结果中,联合治疗组也明显优于其他2组,差异具有统计学意义(P<0·05).结论内镜套扎术联合改良三明治法注射治疗食管胃底静脉曲张出血的近期和远期疗效都十分显著,值得临床推广.
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