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目的:观察经内镜结扎和硬化剂治疗食管静脉曲张的疗效及对门脉高压性胃病(ＰＨＧ)的影响。方法;对９２例患者随机分为套扎组(ｎ＝４３)和硬化剂组(ｎ＝４９),分别在治疗后１~３月和１~３年内复查。观察静脉曲张及ＰＨＧ的转归情况。结果:１~３月内复查套扎组完成２６例,其中食管静脉曲张根除１２例,曲张减轻１２例,无效２例,ＰＨＧ加重１７例。硬化剂组完成２９例,其中静脉曲张根除４例,曲张减轻２２例,无效３例,ＰＨＧ加重１１例。１~３年内复查套扎组和硬化剂组的再曲张率及再出血率分别为６１．５%~６．７%和４４．４%、３３．３%。结论:近期套扎治疗在根治静脉曲张方面优于硬化剂注射,但更易诱发和加重ＰＨＧ。而套扎组和硬化剂组远期均可出现再曲张和再出血。两组比较无差异。
Objective: To observe the efficacy of endoscopic ligation and sclerotherapy for esophageal varices and its effect on portal hypertensive gastropathy (PHG). Methods Totally 92 patients were randomly divided into ligation group (n = 43) and sclerotherapy group (n = 49). The patients were reviewed in 1-3 months and 1-3 years respectively. Observation of varicose veins and the outcome of PHG. Results: Within 1 ~ 3 months, 26 cases were completed in the ligation group, including 12 cases of esophageal varices eradication, 12 cases of variceal lesion, 2 cases of ineffectiveness and 17 cases of PHG exacerbation. Sclerotherapy group completed 29 cases, including 4 cases of varicose root edema, varicose in 22 cases, 3 cases of ineffective, PHG increased in 11 cases. Re-variceal rates and rebleeding rates in the ligation group and the sclerosant group during 1 to 3 years were 61.5% to 6.7% and 44.4%, respectively, and 33.3%, respectively. Conclusions: Ligation is superior to sclerotherapy in the treatment of varices in the near future, but PHG is more likely to be induced and exacerbated. The ligation group and sclerotherapy group may appear long-term varicose and re-bleeding. No difference between the two groups.