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[目的]比较2种不同的三明治夹心法:碘油+组织黏合剂+碘油、聚桂醇+组织黏合剂+聚桂醇对胃静脉曲张的疗效。[方法]入选胃静脉曲张组织黏合剂治疗患者82例,其中碘油组35例,采用传统组织黏合剂三明治夹心法(碘油+组织黏合剂+碘油)治疗;聚桂醇组47例,采用聚桂醇联合组织黏合剂三明治夹心法(聚桂醇+组织黏合剂+聚桂醇)治疗,比较2组的止血成功率、组织黏合剂用量、1周静脉曲张消失率(显效率)、并发症的发生率及1年的再出血率。[结果]碘油组、聚桂醇组止血成功率均为100%。聚桂醇组组织黏合剂总量[(1.82±0.73)ml]少于碘油组的组织黏合剂总量[(3.56±1.39)ml],2组比较差异有统计学意义(P<0.01)。聚桂醇组患者术后显效率、1年再出血率、1年死亡率分别为21.3%、36.2%、21.3%,碘油组分别为17.1%、34.3%、11.4%,2组比较均差异无统计学意义(P>0.05);但聚桂醇组的并发症发生率(2.1%)显著低于碘油组(25.7%),2组比较差异有统计学意义(P<0.05)。[结论]以聚桂醇与以碘油为辅助的三明治夹心法治疗胃静脉曲张的疗效相当,但聚桂醇+组织黏合剂+聚桂醇不良反应作用较小,所用黏合剂少,费用低,更值得临床推广应用。
[Objective] To compare the effects of two different sandwiches sandwich methods: lipiodol + tissue adhesive + lipiodol, lauryl alcohol + tissue adhesive + lauromacyl alcohol on gastric varices. [Methods] 82 patients with gastric varices tissue adhesive were treated, including 35 cases of lipiodol group, which were treated by traditional tissue sandwich sandwich method (lipiodol + tissue adhesive + lipiodol); 47 cases of lauryl alcohol group, The effect of hemostatic success rate, tissue adhesive dosage, the disappearance rate of varicose week (markedly effective rate) and the rate of variceal bleeding were compared between the two groups. The incidence of complications and re-bleeding rate of 1 year. [Result] The success rate of hemostasis in lipiodol group and lauromacrogol group was 100%. The total amount of tissue adhesive in the lauryl alcohol group [(1.82 ± 0.73) ml] was less than that of the lipiodol group [(3.56 ± 1.39) ml], the difference was statistically significant (P <0.01) . The apparent effective rate, 1-year rebleeding rate and 1-year mortality of the lauromacrogol group were 21.3%, 36.2% and 21.3% respectively, while those of the lipiodol group were 17.1%, 34.3% and 11.4% respectively There was no significant difference between the two groups (P> 0.05). However, the complication rate in lauromacrol group (2.1%) was significantly lower than that in lipiodol group (25.7%). There was significant difference between the two groups (P <0.05). [Conclusion] The effects of lauromacrogol and iodized oil sandwich sandwich on the treatment of gastric varices are similar, but lauryl alcohol + tissue adhesive + laguiol has less side effect, less adhesive and low cost , More worthy of clinical promotion and application.