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目的探讨聚桂醇联合组织胶三明治法注射治疗胃静脉曲张的疗效,分析曲张静脉复发的相关危险因素。方法选择沂水中心医院2012年6月至2014年9月收治肝硬化合并胃静脉曲张出血患者65例,随机分为3组,分别行血管内注射聚桂醇、组织胶及二者三明治法联合注射,观察治疗过程中的即时出血率,随访观察有效率,记录复发率,分析复发的相关危险因素。结果组织胶注射剂及三明治法联合注射的安全性高,治疗过程无出血患者,三组治疗有效率均较高,分别为94.4%、89.5%和93.1%,各组之间无明显差异性,联合治疗组复发率为14.3%,较其他两组明显降低,单因素分析显示,肝功能分级与静脉曲张复发有关,肝功能越差,复发率越高。结论聚桂醇联合组织胶三明治法联合注射治疗可明显降低复发率,肝功能Child-Pugh分级是静脉曲张复发的危险因素。
Objective To investigate the curative effect of laurel injection combined with gel sandwiches injection on gastric varices and to analyze the related risk factors of varicose vein recurrence. Methods Sixty-five patients with liver cirrhosis and gastric variceal bleeding were selected from Yishui Central Hospital from June 2012 to September 2014. They were randomly divided into three groups. They were given intravascular injection of Lauryl alcohol, Tissue Glue and the combination of the two methods The rate of immediate bleeding in the course of treatment was observed. The follow-up rate was observed, the recurrence rate was recorded, and the related risk factors of recurrence were analyzed. Results The combination of gel injection and sandwiched method was safe and the treatment did not cause hemorrhage. The effective rates of three groups were 94.4%, 89.5% and 93.1%, respectively. There was no significant difference between the two groups The recurrence rate was 14.3% in the treatment group, which was significantly lower than the other two groups. Univariate analysis showed that the grade of liver function was related to the recurrence of varicose veins. The worse the liver function was, the higher the recurrence rate was. Conclusions Lauryl alcohol combined with glue gel method can significantly reduce the recurrence rate. Child-Pugh classification of liver function is a risk factor of recurrence of varicose vein.