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目的探讨小探头超声检查评价胃底静脉曲张栓塞术的临床价值。方法将肝硬化伴有内镜确诊及可疑胃底静脉曲张患者分为两组,超声组109例(其中急性活动性出血患者67例)中内镜确诊78例,31例可疑胃底静脉曲张小探头超声检查确诊21例,对该组99例确诊患者行组织黏合剂(Histoacryl)栓塞治疗,术后即行超声检查,发现栓塞不完全者再次予以治疗;对照组76例(其中急性活动性出血患者62例),均为内镜诊断明确者,行组织黏合剂栓塞治疗。3个月后两组均采用小探头超声复查,以超声所见评价疗效。结果两组急诊止血率均为100%;超声组3周内无再出血患者,对照组早期再出血率为11.8%(9/76),两组之间差异有非常显著意义(P<0.01);术后3个月小探头超声随访, 超声组中胃底静脉曲张消失率为97.0%(96/99),对照组为76.3%(58/76),两组之间差异亦有非常显著意义(P<0.01)。结论小探头超声检查评价胃底静脉曲栓塞术具有较高的价值。
Objective To evaluate the clinical value of small probe ultrasonography in the evaluation of gastric varices embolization. Methods The patients with cirrhosis complicated with endoscopic diagnosis and suspected gastric fundus varices were divided into two groups. In the ultrasound group, there were 78 cases diagnosed by endoscopy in 109 cases (including 67 cases with acute active hemorrhage), and 31 cases with suspected gastric varices Twenty-one cases were diagnosed by sonographic ultrasonography and 99 cases were diagnosed as Histoacryl embolization. After operation, ultrasound examination was performed to find out incomplete embolism. In the control group, 76 cases (including acute active bleeding 62 cases) were diagnosed by endoscopic diagnosis and treatment of tissue adhesive embolization. After 3 months, both groups were treated with small probe ultrasound to evaluate the effect of ultrasound. Results The rate of hemostasis was 100% in both groups. The rate of early rebleeding in the control group was 11.8% (9/76) in the 3 weeks without any rebleeding. The difference between the two groups was significant (P <0.01) ; 3 months after operation, sonographic follow-up of small probe, the disappearance rate of gastric varices in the ultrasound group was 97.0% (96/99), the control group was 76.3% (58/76), the difference between the two groups is also very significant (P <0.01). Conclusion Small probe ultrasonography in the evaluation of gastric varices embolization has a high value.