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目的探讨透明帽辅助内镜下硬化治疗肝硬化食道静脉曲张破裂出血中的应用价值。方法 2009年6月-2012年3月该院对77例肝硬化食道静脉曲张破裂出血患者随机分组,分别采用透明帽辅助内镜下硬化治疗(CFG)和常规内镜下硬化治疗(NCF),CFG组硬化剂注射后针孔用内镜先端透明帽进行压迫,NCF组硬化剂注射后针孔用内镜镜身进行压迫。比较分析两组硬化剂治疗后压迫效果,6周后食管溃疡发生率、出血发生率和静脉曲张消失率。结果 CFG组压迫后再出血的发生率较NCG组明显减少;虽然6周后两组食管溃疡发生率差异无显著性,但CFG组食管深溃疡的发生率明显减少,6周后再出血的发生率也较NCF组较少;静脉曲张消失率差异无显著性。结论透明帽辅助内镜下硬化治疗食道静脉曲张破裂出血,保持视野清晰,起到固定靶静脉,注射后压迫方便,明显减少压迫后再出血率,较少术后深溃疡形成,再出血的发生率,该方法值得临床借鉴。
Objective To investigate the value of transparent cap-assisted endoscopic sclerosis in the treatment of cirrhosis and esophageal variceal bleeding. Methods From June 2009 to March 2012, 77 patients with cirrhosis esophageal variceal bleeding were randomly divided into transparent cap-assisted endoscopic sclerosis (CFG) and conventional endoscopic sclerotherapy (NCF) After injection of sclerosant in CFG group, the pinholes were compressed with a transparent end cap of the endoscope, and the pinhole of the NCF group was compressed with an endoscope. Comparisons were made between the two groups of sclerotherapy after the treatment of oppression, the incidence of esophageal ulcers after 6 weeks, the incidence of bleeding and varicose veins disappear. Results The incidence of rebleeding after compression in CFG group was significantly lower than that in NCG group. Although there was no significant difference in the incidence of esophageal ulcer between the two groups after 6 weeks, the incidence of esophageal ulcer in CFG group decreased significantly and rebleeding occurred after 6 weeks Rate is also less than the NCF group; Varicose veins no significant difference. Conclusion Transparent cap assisted endoscopic sclerosis in the treatment of esophageal variceal bleeding, to maintain a clear field of vision, to play a fixed target vein, convenient compression after injection, significantly reduce the rebleeding rate after compression, less postoperative deep ulcer formation, rebleeding occurred Rate, the method deserves clinical reference.