内镜下套扎或注射硬化剂联合抗病毒治疗对乙型肝炎肝硬化食管静脉曲张再出血的影响  

The influence of endoscopic variceal ligation or tissue glue injection combined with antiviral therapy for rebleeding of esophageal varicose vein of hepatitis B cirrhosis

作　　者：肖绍树 朱珊玲 刘荣[1] 叶俊[1] 陈红[1] 纪昌林[1] 刘洋[1] 胡志勇[1] 贺降福[1] 

机构地区：[1]湖北省黄石市第五人民医院消化内科,黄石市435005

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第2期74-77,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨内镜下套扎或注射硬化剂联合抗病毒治疗对乙型肝炎肝硬化食管静脉曲张再出血的影响。方法 65例乙型肝炎肝硬化食管静脉曲张患者,其中33例选择内镜下套扎或注射硬化剂联合抗病毒治疗(联合治疗组),另32例单纯选择内镜下套扎或注射硬化剂治疗(未经抗病毒治疗组)。随访6~48个月,平均26.5个月。观察食管曲张静脉复发及再出血和肝功能变化。结果联合治疗组患者静脉曲张复发率为12.50%(4/32),出血率为6.25%(2/32);未经抗病毒治疗组患者静脉曲张复发率为30.00%(9/30),出血率为20.00%(6/30),差异具有统计学意义(x^2=11.32,P<0.01)。联合治疗组患者肝功能按Child-Pugh评分标准,平均分为(7.0±0.8),未抗病毒治疗组患者平均分为(9.0±1.9),差异具有统计学意义(t=2.12,P<0.05)。结论乙型肝炎肝硬化食管静脉曲张内镜下套扎或注射硬化剂联合抗病毒治疗能取得更好的疗效。Objecive To investigate the influence of endoscopic variceal ligation or tissue glue injection combined with antiviral therapy for rebleeding of esophageal varicose vein of patients with hepatitis B cirrhosis.Methods Total of 65 patients with hepatitis B cirrhosis with esophageal varices were collected.There were 33 patients wree selected endoscopic variceal ligation or tissue glue injection combined with antiviral therapy（combination therapy group）,the others were simply chosen endoscopic variceal ligation or tissue glue injection（without antiviral treatment group）.All patients were followed up for 6-48 months,with an average of 26.5 months.The recurrence rate of esophageal varicose vein,rebleeding rate and the changes of liver function were analyzed,respectively.Results In the combination therapy group,the recurrence rate of varicose veins was 12.50%（4/32）,the bleeding rate was 6.25%（2/32）;of which in the without antiviral treatment group were 30.00%（9/30） and 20.00%（6/30）,respectively,with significant differences（x^2= 11.32,P 〈0.01）.The average score of liver function based on Child-Pugh grading system in the combination group was（7.0 ± 0.8）,in which without antiviral treatment group was（9.0 ± 1.9）,the difference was statistically significant（t = 2.12,P〈 0.05）.Conclusions The patients of hepatitis B cirrhosis with esophageal varicose could obtain a better curative effect from endoscopic variceal ligation or tissue glue injection combined with antiviral therapy treatment.

关 键 词：肝炎 乙型 肝硬化 食管静脉曲张 套扎术 抗病毒 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学] R571.3