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1、食管/食管+胃静脉曲张结扎术治疗胃静脉曲张的对比研究何兰英，陈伟庆(400010重庆，垂庆医科大学附属第二医院消化内科)［摘要］目的评佔内镜下行食管、胃底静脉曲张结扎术(EGVL)和单独行食管静脉Illi张结扎术(EVL)治疗不同类型胃静脉曲张(GV)的有效性,并分析影响术后效果的因素。方法回顾性总结我院90例行EGVL治疗(EGVL组)和141例行EVL治疗(EVL组)的GV患者的临床资料:对比分析两组及各型GV间在GV曲张度、术后GV消除率、再出血率、复发率、生存时间等方面的差异，分析胃/脾-肾分流对
2、GV患者术后疗效的影响。结果两组GOVI间、G0V1+G0V2间及IGV1间的GV
3、11
4、张度差异有统计学意义(P>0.05),两组G0V2间GV曲张度有差异(P<0.01)；EGVL组:止血成功率97.8%,消除率92.2%,复发率13.3%,再出血率18.2%；EVL组:止血成功率92.9%,消除率55.2%,复发率10.8%,再出血率32.8%,曲张静脉消除率和再出血率差异有统计学意义(X2=35.155,P<0.01；x2=5.734,P-0.017),两组间复发率无差异(P>0.05)；两组G0
5、V1间、G0V1+G0V2间的消除率和再出血率差异有统计学意义(PW0.01)；两组G0V2间仅消除率差异有统计学意义(P<0.01),但再出血率差异无统计学意义(P>0.05)；两组相同型别间的生存时间无差异(P>0.05)o±腹部CTA结果示：58.3%(42/72)的GV伴胃/脾-肾分流,有、无胃/脾-肾分流患者之间GV复发率和再出血率差异有统计学意义(xJ9.914,P<0.01：x2=7.200,P<0.01)o结论GV患者在行EGVL术后GV消除、再出血优于EVL术。EGVL和EVL治疗各型G
6、V急性出血及预防再出血是有效的。胃/脾-肾分流对GV复发和再出血有影响。［关键词］食管并胃静脉曲张；结扎术；术后再出血、复发；胃/脾-肾分流［中图法分类号］R575.2+1［文献标志码］AAretrospectivestudyofesophagealvaricesbandligationversusesophagealandgastricvaricesbandligationinthemanagementofbleedinggastricvaricesHeLanying,ChenWciqing(Dcpar
7、tmcntofGastroenterology,TheSecondAffiliatedHospitalofChongqingMedicalUniversity,Chongqing400010,China)[Abstract]ObjectiveThepurposeofthethesiswastoassesstheefficacyofthetreatmentofgastricvarices(GV),whichcontainedesophagealandgastricvaricesbandligation(EG
8、VL),Separatelineofesophagealvaricesbandligation(EVL),andsearchedfortheinfluencingfactorsofpostoperativeeffect.MethodsThethesisretrospectivelysummarizedclinicaldataofGVpatientswhoreceivedtwotypesoftreatmentinourdepartment:90patientsreceivedEGVL,andanother1
9、41patientsreceivedEVL.ThethesiscomparedthediflereneeinthedegreeofGVvarices,postoperativeeliminationrate,rebleedingrate,recurreneerateandsurvivaltimebetweenthetwogroups,andthen,analysisedtheeffectofthestomach/spleen-kidneyshuntsonpostoperativepatientswithG
10、VResultsTheconsequencesofthecomparisonrevealedthattherewasnodifferenceeitherbetweenthetwogroupsofGOV1orbetweenGOV1+GOV2,aswellasthedegreeofGVvaricesbetweenIGVl(P>0.05).However,therewasdifferenceinthedegreeofGVvarice
