三腔两囊管在食管胃静脉曲张大出血院前急救中的应用  

Application of Sengstaken-Blakemore tube in treatment of esophageal and gastric variceal bleeding in pre-hospital care

作　　者：程瑶[1] 郝艾香 纪桂贤[2] 

机构地区：[1]秦皇岛市第一医院院前急救科,066000 [2]秦皇岛市第一医院院消化内科,066000

出　　处：《肝脏》2015年第1期8-10,共3页Chinese Hepatology

摘　　要：目的探讨院前应用三腔两囊管救治食管胃静脉曲张大出血的可行性及疗效。方法回顾性分析秦皇岛市第一医院2011年1月至2014年1月院前接诊的食管胃静脉曲张大出血患者86例,随机分为两组,对照组44例,给予垂体后叶素等常规治疗;三腔管组42例,常规治疗基础上紧急行三腔两囊管压迫止血。两组入院后药物治疗相同,比较两组临床疗效。结果三腔管组止血成功37例,占88.10%,对照组止血成功37例,占84.09%,两组比较,差异无统计学意义(P>0.05);三腔管组平均止血时间、治疗后出血量、输血量、住院天数均明显优于对照组,差异有统计学意义(P<0.05);三腔管组不良反应发生率为81.0%高于对照组的22.7%,差异有统计学意义(P<0.01)。结论三腔两囊管紧急止血迅速有效,适用于院前急救,但应严格掌握适应证。Objective To investigate the feasibility and efficacy of Sengstaken-Blakemore tube （S-B tube）in pre-hospital treatment of esophageal and gastric variceal bleeding （EGVB）patients.Methods From Jan.2011 to Jul.2013, clinical data of pre-hospital care among 86 EGVB patients were enrolled and retrospectively analyzed.All patients were randomly divided into two groups.Control group （44 cases）received pituitrin and other conventional treatment.On the basis of control group treatment,S-B tube was performed in S-B tube group （42 cases）.Both groups were administiated with the same drug treatment after admission and then the clinical efficacy was compared.Results There was no significant difference in the hemostatic rate between S-B tube group and control group （88.10% vs 84.09% ,P 〉0.05）;however,the average time of hemostasis,amount of bleeding after treatment,amount of blood transfusion and hospital stay of S-B tube group were significantly improved than those of control group （P 〈0.05）;incidence of adverse reactions in S-B tube group was significantly higher than that in control group （81 .0% vs 22.7%,P 〈0.01 ）.Conclusion S-B tube in treatment of EGVB patients was rapid,effective and suitable for pre hospital care.But the indications should be controlled strictly.

关 键 词：三腔两囊管 食管胃静脉曲张出血 院前急救 垂体后叶素 

分 类 号：R575.2[医药卫生—消化系统]