强化营养治疗促进肝硬化食管静脉曲张镜治疗患者创面的愈合  

Enhanced nutritional therapy may promote wound healing after endoscopic therapy in patients with liver cirrhosis and esophageal varices

作　　者：李长政[1] 李青山[1] 李雪[1] 闫军红[1] 王瑞玲[1] 蒋仁秀[1] 

机构地区：[1]第二炮兵总医院消化科,北京100088

出　　处：《中华肝脏病杂志》2013年第10期739-742,共4页Chinese Journal of Hepatology

摘　　要：目的 探讨强化营养治疗对肝硬化伴有食管静脉曲张接受内镜治疗患者创面愈合的影响. 方法 肝硬化伴食管静脉曲张接受内镜治疗患者50例,随机分为：强化营养治疗组25例,对照组25例.对照组给予常规饮食及药物治疗,每周1次内镜下硬化剂注射治疗,强化营养治疗组在此基础上给予包括肝营养素在内的强化营养治疗.比较两组患者食管静脉曲张转归及创面愈合的差异.结果 患者治疗期间每周复查,强化营养治疗组注射点累计溃疡发生率为64％,明显低于对照组的92％,两组比较,x2=5.711,P=0.017,差异有统计学意义；强化营养治疗组内镜检查注射点溃疡处少量渗血累计仅有1例,低于对照组的7例,两组比较,x 2=5.357,P=0.021,差异有统计学意义.静脉曲张消失平均需要3.8次内镜治疗,低于对照组的4.1次,两组比较,t=2.069,P=0.044,差异有统计学意义. 结论 对于肝硬化伴有食管静脉曲张接受内镜下硬化治疗的患者,强化营养治疗可促进内镜治疗后局部损伤的愈合和血管闭塞,预防并发症发生及提高总体疗效.Objective To investigate the effect of enhanced nutritional therapy on wound healing after endoscopic therapy in patients with liver cirrhosis and esophageal varices.Methods Fifty patients with liver cirrhosis and esophageal varices were randomly divided into an enhanced nutritional therapy group （n =25） and a control group （n =25）.The enhanced nutritional therapy group received one week of enhanced nutritional supplementation,including liver nutritional elements,prior to routine endoscopic therapy.The routine without any change to their dietThe rate of transformation and status of wound healing of esophageal varices were compared between the two groups.Results The ratio of ulcers occurring at the injection site was lower in the enhanced nutrition group than in the control group （16/25 vs.23/25;x2 =5.711,P =0.017）.The enhanced nutrition group had only one case of minimal bleeding occurring during endoscopy as compared to the seven cases of bleeding in the control group （x2 =5.357,P =0.021）.On average,the enhanced nutrition group required less sessions of endoscopic treatment to achieve eradication of esophageal varices than the control group （3.8 vs.4.1; t =2.069,P=0.044）.Conclusion Pre-endoscopic enhanced nutritional therapy may benefit patients with liver cirrhosis and esophageal varices by promoting recovery of procedure-related local tissue injury and occlusion of varices. Keywords：Liver cirrhosis; Esophageal varices; Nutritional therapy; Endoscopic therapy;Wound healing

关 键 词：肝硬化 食管静脉曲张 营养治疗 内镜治疗 创面愈合 

分 类 号：R575.2[医药卫生—消化系统]