Efficacy Analysis of Ｇastroscopic Metal Titanium Clip Combined with Medical Adhesive in the Treatment of Gastric Fundal Varices

Abstract

Abstract:

Objective： To investigate the clinical efficacy of gastroscopic metal titanium clip combined with medical adhesive in the treatment of gastric fundal varices. Methods： A retrospective analysis was performed on the medical records of 80 patients who underwent gastroscopic treatment for gastric fundal varices with medical adhesive at the Endoscopy Center of the First People's Hospital of Dali City from June 1， 2020 to June 30， 2021. The clinical efficacy and safety of the monotherapy（monotherapy group） and metal titanium clip combined therapy（combined group） were compared. Results： Compared with the monotherapy group， the combined group had a significantly increased amount of medical adhesive used， with a statistically significant difference（P<0.05）. However， the rebleeding rate between the two groups was only statistically significant at 3 months after surgery（P<0.05）， while there was no statistically significant difference at other time points（P>0.05）. Additionally， no cases of ectopic embolism occurred during the 12-month follow-up period in both groups. Conclusion： Gastroscopic metal titanium clip combined with medical adhesive in the treatment of gastric fundal varices can reduce the rate of rebleeding and is a safe and effective treatment method.

Key words:

gastric fundal varices, medical adhesive, metal titanium clip, rebleeding, ectopic embolism

CLC Number:

R575.2 ','1');return false;" target="_blank">
R575.2

Ma Mengxia, Tao Zhongyuan, Guo Shunhong, Zhao Chunping, Li Bowen, Zhang Qinyuan.

Efficacy Analysis of Ｇastroscopic Metal Titanium Clip Combined with Medical Adhesive in the Treatment of Gastric Fundal Varices [J]. Journal of Dali University, 2023, 8(10): 34-37.

References

〔1〕 SEMMLER G， SCHEINER B， SCHWABL P， et al. The Impact of Hepatic Steatosis on Portal Hypertension〔J〕. PLoS One，2019，14（11）：e0224506.

〔2〕中华医学会肝病学分会，中华医学会消化病学分会，中华医学会内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治指南〔J〕. 临床肝胆病杂志，2016，32（2）：203-219.

〔3〕刘淼.胃镜下金属钛夹联合组织胶“三明治”疗法治疗肝硬化胃底静脉曲张疗效的研究〔D〕.泸州：西南医科大学，2020.

〔4〕 SARIN S K， KUMAR A. Gastric Varices： Profile， Classi-fication， and Management〔J〕. Am J Gastroenterol，1989，

84（10）：1244-1249.

〔5〕 SOEHENDRA N， NAM V C， GRIMM H， et al. Endo-scopic Obliteration of Large Esophagogastric Varices with Bucrylate〔J〕. Endoscopy，1986，18（1）：25-26.

〔6〕 ROBERTO D F. Expanding Consensus in Portal Hyperten-sion： Report of the Baveno Ⅵ Consensus Workshop： Stratifying Risk and Individualizing Care for Portal Hypertension〔J〕. J Hepatol，2015，63（3）：743-752.

〔7〕 ELSEBAEY M A， TAWFIK M A， ELSHWEIKH S A， et al. Impact of Helicobacter pylori Infection on Gastric Variceal Bleeding among Patients with Liver Cirrhosis〔J〕. Gastro-enterol Res Pract，2019：6529420.

〔8〕 TSENG Y， MA L， LUO T， et al. Patient Response to Endoscopic Therapy for Gastroesophageal Varices Based on Endoscopic Ultrasound Findings〔J〕. Gut Liver，2018，

12（5）：562-570.

〔9〕 MIYOSHI H， SHIKATA J， TOKURA Y. Endoscopic Clipping of Esophageal Varices〔J〕. Dig Endosc， 1992， 4（2）： 147-150.

〔10〕马佳丽，李坪，周玉玲，等.胃静脉曲张内镜下组织粘合剂注射治疗后排胶出血的临床观察〔J〕.肝脏，2016，21（12）：1033-1034.

〔11〕朱元东，施言，谢欣城，等.内镜下钛铗联合组织胶治疗中重度胃底静脉曲张的临床效果〔J〕.中华临床医师杂志（电子版），2019，13（10）：731-735.

〔12〕程志才，班秀丽.内镜下套扎术联合组织胶注射治疗和预防食管胃底静脉曲张破裂出血的临床应用〔J〕.中国社区医师，2015（1）：62-63.

〔13〕梅长红，李会贤，王曦，等.内镜下金属钛夹联合组织胶注射治疗胃底静脉曲张22例〔J〕.安徽医药，2019，23（12）：2420-2423.

〔14〕王芳，刘仕倩，曾西，等.食管胃底静脉曲张伴自发性分流血管栓塞治疗的研究进展〔J〕.胃肠病学和肝病学杂志，2018，27（3）：346-350.

〔15〕 ZENG X Q， MA L L， TSENG Y J， et al. Endoscopic Cyanoacrylate Injection with or without Lauromacrogol for Gastric Varices： A Randomized Pilot Study〔J〕. J Gastro-enterol Hepatol，2017，32（3）：631-638.

〔16〕曹传坤，孔德润.内镜下精准食管胃静脉曲张断流术83例初步研究〔J〕.中华消化内镜杂志，2018，35（2）：99-104.