超聲內鏡下選擇性食管胃靜脈曲張來源支穿刺組織膠封閉術與傳統(tǒng)內鏡治療的隨機對照研究

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Abstract:ObjectiveToinvestigatethesafetyand eficacyof puncturecyanoacrylateselectiveseal(PCSS)underendoscopic ultrasound inthetreatmentofgastroesophageal varices(GOV).MethodsAtotalof10patientswith livercirrhosiswho underwentendoscopictherapyforthesecondarypreventionofGOVbleeding inBeijingDitan Hospital,,CapitalMedicalUniversity, from March1to December31,2023 were enroledandrandomlydivided intoPCSS groupandtraditional endoscopygroup.The patients werefolowedupfor6monthsaftersurgery,andthetwogroups werecomparedintermsofclinical outcomeand complications.The primaryoutcome measure wastherateof allviationordisappearanceofGOV,and thesecondaryoutcome measure was variceal rebleeding and death.The independent-samples t test was used for comparison of normally distributed or aproximatelynormall distributedquantitativedatabetweentwogoups,and the Wilcoxon non-parametric test wasused for comparisonofnon-normalldistributedquantitativedatabetweentwogroups;thechi-squaretestortheFisher’sexacttestwasused forcomparisonof qualitative data between two groups.ResultsThere were 50 patients inthe PCSS group,among whomlpatient waslosttofollow-up,andtherewere5Opatients inthetaditionalendoscopygoup,mong whom3patients werelosttofollow-up. There werenosignificantdiferencesbetweenthetwo groups inbaselinedatasuchasage,sex,Child-Pughclass,varices grade, and GOV typing(all P>0.05 ).Compared with the traditional endoscopy group,the PCSS group had significantly better results of the number of endoscopic treatment sessions ( t=-15.671 , P =0.001),the total amount of tissue adhesive used( t=-2.830 , P= 0.006),and the rate of alleviation or eradication ofvarices sclerosis( χ2 =7.078, P =0.029).Both groups had low rates of postoperativerebleeding,adversereactions,andcomplications,andtherewerensignificant diferences between the two groups (all P>0.05 ).ConclusionCompared with traditional endoscopy,PCSS can significantly enhance treatment outcome while maintaining safety standards.
Key Words:Esophageal and Gastric Varices;Echoendoscope;Embolization,Therapeutic; Treatment Outcome
Research funding:Beijing Municipal Administration of Hospitals Incubating Program(PX2023065)
食管胃靜脈曲張(gastroesophageal varices,GOV)破裂出血是肝硬化致死性并發(fā)癥[1]。(剩余10936字)