内镜下套扎术联合药物治疗食管静脉曲张出血的效果  

The efficacy of combining endoscopic looping ligature with drug for esoph ageal varices bleeding

作　　者：李莉[1] 陈洁[1] 刘春燕[1] 张军[1] 李菲菲[2] 

机构地区：[1]浙江省湖州市中心医院消化内科,浙江湖州313000 [2]内蒙古医科大学附属医院消化内科,内蒙古呼和浩特010059

出　　处：《中国医药导报》2014年第17期31-33,49,共4页China Medical Herald

基　　金：内蒙古自治区自然科学基金资助项目(编号2012MS11111);浙江省湖州市科技计划项目(编号2008YS13)

摘　　要：目的探讨食管静脉曲张出血行内镜下套扎术联合药物治疗的效果。方法选择2011年10月-2013年10月在浙江省湖州市中心医院诊治的食管静脉曲张出血患者124例，按照随机数字表法分成两组，每组各62例，对照组予以内镜下套扎术联合常规止血抗炎药物治疗，研究组予以内镜下套扎术与泮托拉唑、生长抑素、普萘洛尔等联合药物治疗，分析不同分级的再出血、两组止血效果、并发症情况。结果不同Child—Pugh分级再出血率比较，Child—PughC级明显高于Child—PughA及B组，差异有统计学意义（P〈0．05）。且研究组出血再发率为3．23％．复发率为6．45％，比对照组（19．35％、24．19％）降低，差异有统计学意义（P〈0．05）。同时研究组伴发食管溃疡、门脉高压胃病发生率为3．23％、3．23％，比对照组（19．35％、20．97％）降低，差异有统计学意义（P〈0．05）。结论针对食管静脉曲张出血患者，予内镜下套扎术与联合药物治疗，患者的止血效果良好，且并发症较少，具有一定临床应用和研究价值。Objective To explore the efficacy of combining endoscopic looping ligature with drug to esophageal varices bleeding. Methods From October 2011 to October 2013 in Huzhou Central Hospital of Zhejiang Province, 124 patients with esophageal variees bleeding were randomly selected and these were divided into two groups according to random number table method, 62 cases were treated with endoscopic looping ligature combined routine hemostatic anti-inflam- matory drugs as experiment group, such as Pantoprazole, somatostatin and Naphthalene, the control group were done with ordinary methods. The different of two groups on classification of bleeding, hemostatic effect and complications were analyzed. Results The different comparison of Child-Pugh for grading and bleeding rate, Child-Pugh C grade was obvious higher than Child-Pugh A and B grade with statistical significance （P 〈 0.05）. And bleeding of experiment group was 3.23%, which was less than the control group （19.35%）; relapse rate of experiment group was 6.45%, which was less than the control group （24.19%） with statistical significance （P 〈 0.05）. At the same time the experiment group with esophageal ulcers, portal hypertension gastropathy were 3.23% and 3.23%, the control group were 19.35% and 20.97%, there were statistical significance between two groups （P 〈 0.05）. Conchlsion The efficacy of combining endo- scopic with drug to esophageal varices bleeding are better than ordinary methods, combining methods has less compli- cations, and high research value.

关 键 词：食管静脉曲张出血 内镜下套扎术 效果 

分 类 号：R575.2[医药卫生—消化系统]