不同硬化剂在肝硬化食管静脉曲张破裂出血序贯治疗中的效果分析  

Effect of Sequential Therapy with Different Hardening Agent in Cirrhosis Esophageal Varices Rupture Bleeding Patients

作　　者：黄鹤[1] 伦伟健[1] 梁晓燕[1] 刘浏[1] 贾柳萍[1] 

机构地区：[1]南方医科大学附属南海医院消化内科,广东佛山528200

出　　处：《四川医学》2015年第10期1400-1403,共4页Sichuan Medical Journal

摘　　要：目的探讨套扎+硬化序贯治疗中不同硬化剂对治疗效果的影响。方法纳入我院2012年至2014年收治的肝硬化食管静脉曲张破裂出血患者77例,按照随机数字表法将患者分为EVL联合鱼肝油酸钠硬化序贯治疗组(n=38)及EVL联合聚桂醇硬化序贯治疗组(n=39)。采用密集结扎法后分别给予5%鱼肝油酸钠及聚桂醇,比较两组患者静脉曲张静脉治疗有效率、静脉曲张复发率、并发症发生率。结果 EVL联合鱼肝油酸钠组治疗后曲张静脉完全消失例数为34例,基本消失例数2例,有效率94.7%;EVL联合聚桂醇组治疗后曲张静脉完全消失例数为33例,基本消失例数3例,有效率92.3%;两组患者有效率比较差异无统计学意义(P>0.05)。EVL联合鱼肝油酸钠组复发6例(15.8%),EVL联合聚桂醇组复发3例(7.7%),两组患者复发率差异有统计学意义(P<0.05)。VL联合鱼肝油酸钠组共有39例次(26.4%)的患者接受治疗后出现并发症,以发热居多。EVL联合聚桂醇组共有16例次(18.8%),的患者接受治疗后出现并发症,以发热、胸痛居多。两组患者并发症率比较差异有统计学意义(P<0.05)。结论套扎+硬化序贯治疗(EVLS)疗效确切,EVL联合聚桂醇硬化序贯治疗的曲张静脉复发率、并发症发生率低于5%鱼肝油酸钠,硬化剂的选择上推荐使用聚桂醇。Objective To observe the efficacy of endoscopic variceal ligadon joint esophageal variceal sclerotherapy with different hardeners for esophageal variceal bleeding. Methods 77 patients with esophageal varices bleeding in our hospital from 2012 to 2014 according to the random number table method were divided into EVL combined with cod-liver oil acid hardening se-quential therapy group （n=38） and EVL combined with lauromacrogol sclerotherapy sequential therapy group（n=39）. Patients were given 5% cod-liver oil acid sodium and lauromacrogol after dense ligation. Then two groups of patients with varicose vein treatment efficiency,variceal recurrence rate,complication rate were compared. Results After treatment 34 cases varicose veins completely disappeared in EVL combined with sodium morrhuate group,2 cases disappeared,efficiency 94. 7%;33 cases varicose veins completely disappeared in EVL combined with lauromacrogol sclerotherapy sequential therapy group,3 cases disappeared,ef-ficiency 92. 3%. There were no significant difference of efficiency between two groups（P〉0. 05）. 6 cases（15. 8%） of EVL com-bined with cod liver oil acid sodium group recurrence,3 cases（7. 7%） of EVL combined with lauromacrogol sclerotherapy sequen-tial therapy group recurrence. There were significant difference of recurrence rate between two groups （ P 〈0. 05 ） . 39 cases （26. 4%）of EVL combined with sodium morrhuate group after treatment complications,mostly by fever. 16 cases（18. 8%）of EVL combined with lauromacrogol sclerotherapy sequential therapy group after treatment complications, mostly by fever, chest pain. There were significant difference of complication rate between two groups（P〈0. 05）. Conclusion Ligation ＋ sclerotherapy treat-ment curative effect,EVL combined with lauromacrogol sclerotherapy sequential therapy had less recurrence rate and complication rate. The hardening agent selection recommended to use lauromacrogol.

关 键 词：肝硬化 食管静脉曲张 曲张静脉硬化术 曲张静脉套扎术 硬化剂 

分 类 号：R575.2[医药卫生—消化系统]