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目的探讨食管静脉曲张(EV)经内镜下套扎序贯硬化(EVLS)根除治疗后影响复发的因素。方法对61例食管静脉曲张患者行EVLS治疗达到根除标准后随访2年,依据复发时间分为高危组(24月内复发)与低危组(24月内未复发),收集食管静脉曲张经内镜治疗达到根除标准时患者的生化及随访期间的临床资料进行统计学分析。结果 2年内食管静脉曲张复发24例(39.3%),未复发37例(60.7%);高危组与低危组在出血、脾功能亢进、糖尿病和中/重度腹水的发生率以及Child-Pugh评分、血清白蛋白、血小板计数、凝血酶原时间和超声测量门静脉直径等方面差异有统计学意义(P均<0.05);进一步行非条件Logistic回归分析显示出血史、中/重度腹水和糖尿病病史(OR值分别为9.7,6.5和10.8)是食管静脉曲张复发的独立危险因素。结论出血、中/重度腹水、糖尿病是食管静脉曲张复发的独立危险因素,对该类患者应积极随访和再治疗。
Objective To investigate the factors that affect the recurrence of esophageal varices (EV) after endoscopic eradication of enalapril (EVLS). Methods Sixty-one patients with esophageal varices underwent eradication of EVLS. The patients were followed up for 2 years. According to the recurrence time, they were divided into high-risk group (relapse within 24 months) and low-risk group (no recurrence within 24 months) The patient’s biochemistry and clinical data during the follow-up period when the mirror treatment reached the eradication standard were statistically analyzed. Results The recurrence rate of esophageal varices in 24 cases (39.3%) and no recurrence in 37 cases (60.7%) in 2 years. The incidence of hemorrhage, hypersplenism, diabetes mellitus and moderate / severe ascites and the Child-Pugh score , Serum albumin, platelet count, prothrombin time, and portal vein diameter measured by ultrasound were all significantly different (all P <0.05); further non-conditional Logistic regression analysis showed that the history of bleeding, the history of moderate / severe ascites and diabetes mellitus OR values of 9.7, 6.5 and 10.8, respectively) were independent risk factors for recurrent esophageal varices. Conclusions Bleeding, moderate / severe ascites and diabetes mellitus are independent risk factors for recurrent esophageal varices. These patients should be actively followed up and re-treated.