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目的探讨外科手术与内镜下治疗肝硬化食管静脉曲张破裂出血的再出血及病死率的远期疗效。方法肝硬化门静脉高压症并发食管静脉曲张破裂出血患者93例,分为内镜下治疗组(44例)及外科手术治疗组(49例)。对两组患者治疗后的再出血及病死率进行回顾性研究。结果内镜治疗组中,5例(11.4%)发生再出血;外科手术治疗组中,4例(8.2%)发生再出血,二者差异无统计学意义(P>0.05)。内镜治疗组中,7例(16.0%)死亡;外科手术治疗组中,15例(30.6%)死亡,二者之间差异有统计学意义(P<0.05)。结论内镜下治疗和外科手术治疗对预防食管静脉曲张破裂出血的再出血有相近的作用,前者的病死率较低,而且操作简便易行,因此在防治食管静脉曲张出血中,应首选前者。
Objective To investigate the long-term efficacy of surgical treatment and endoscopic treatment of rebleeding and mortality of cirrhotic esophageal variceal bleeding. Methods Ninety - three patients with portal hypertension and cirrhosis complicated with esophageal variceal bleeding were divided into endoscopic group (44 cases) and surgical group (49 cases). Retrogression and case-fatality rates after treatment in both groups were retrospectively studied. Results In the endoscopic treatment group, rebleeding occurred in 5 patients (11.4%). In the surgical treatment group, rebleeding occurred in 4 patients (8.2%). There was no significant difference between the two groups (P> 0.05). In the endoscopic treatment group, 7 cases (16.0%) died and 15 (30.6%) died in the surgery group. The difference was statistically significant (P <0.05). Conclusion Endoscopic treatment and surgical treatment have a similar effect on the prevention of rebleeding of esophageal variceal bleeding. The former has lower mortality and is simple and easy to operate. Therefore, the former should be the best choice in the prevention and treatment of esophageal variceal bleeding.