| Objective: to study the clinical effect of endoscopic titanium clip combined with tissue glue "sandwich" in the treatment of decompensated gastric varicose veins in cirrhosis.Methods:patients were divided into three groups:group A was treated with titanium clip combined with tissue glue "sandwich" sandwich injection therapy group,group B was treated with tissue glue + lauromacrogol "sandwich" therapy group,and group C was treated with clinical drugs,with 18-20 patients in each group.Group A,titanium clip combined with treatment group: titanium clip was placed on both ends of the varicose gastric bottom vein in advance during the gastroscopy,part of the blood flow was blocked and the varicose gastric bottom vein slightly collapsed.Tissue glue + lauryl alcohol injection was applied for treatment,and gastroscopy was performed regularly.Group B: tissue glue + lauromacrogol "sandwich injection therapy" was the main treatment,with regular gastroscopy.Group C: patients in the clinical treatment comparison group were mainly treated with drugs and underwent regular gastroscopy.At the same time,the basic clinical data of each patient were recorded,including the shape and degree of varicose vein after treatment,the course of endoscopic treatment,intraoperative blood loss,intraoperative tissue glue and lauromacrogolinjection,and titanium clip placement.Gastroscopy was reexamined at 2 weeks1 month and 6 months after treatment,and the postoperative bleeding,bleeding,removal of varicose veins,loss of titanium clips,and complications such as large ulcer,fever and ectopic embolism were recorded during the period(6 months after treatment).In case of acute and rebleeding before,during and after surgery,endoscopic examination and treatment should be conducted in time,and the causes and amount of bleeding should be recorded.Relevant data of three groups of patients were collected and compared horizontally.The general clinical baseline data,short-term and long-term treatment effect,rebleeding rate,post-treatment complication rate,social life quality and physical and mental health of the three groups were compared.Results: 1.The short-term and long-term effective rates of titanium clip combined treatment group(group A),tissue glue sandwich treatment group(group B),and drug treatment group(group C)were as follows: short-term:group A(93.33%),group B(84.44%),and group C(50.00%).long-term:group A(72.22%),group B(55.63%)and group C(35.00%).The effective rate of treatment of gastric varicose veins in the three groups was significantly different between the groups(P<0.05),which was statistically significant.2.The rates of rebleeding after treatment in the titanium clip combined treatment group(group A),tissue glue sandwich treatment group(group B)and drug treatment group(group C)were 5.00%?16.73%?25.00%,respectively,with significant differences among the three groups(P<0.05,indicating statistical significance).3.Complications of the three groups after treatment were fever,abdominal infection,deep ulcer,rebleeding,ectopic embolism,etc.The transverse comparison showed that there were slight differences among the three groups in fever,abdominal infection,deep ulcer,ectopic embolism,etc.4.Social function assessment and physical and mental health of the three groups of patients were conducted after treatment.The mental and physical health rate of the titanium clip combined treatment group(group A)was significantly higher than that of the other two groups.P<0.05 was statistically significant between the groups.5.Comparison of the average amount of tissue glue in the A?B groups: group A was less than group B,P<0.05,indicating statistical significance.Conclusion: the combined treatment of decompensated gastric varicose veins under gastroscope with metallic titanium clips is effective,safe and worthy of clinical promotion. |
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