限制性液体复苏和控制升压治疗肝硬化门脉高压食管胃底静脉曲张破裂出血的临床疗效  

Clinical efficacy of limited fluid resuscitation and controlled boost of the treatment of esophageal gastric varices bleeding in patients with cirrhosis and portal hypertension

作　　者：蔡珍华 郭岚岚 刘开渊 郑建军 

机构地区：[1]南京军区福州总院附属第一医院(莆田九五医院)消化内科,福建莆田351100

出　　处：《临床和实验医学杂志》2016年第24期2438-2440,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨限制性液体复苏和控制升压治疗肝硬化门脉高压食管胃底静脉曲张破裂出血的临床效果。方法将80例肝硬化门脉高压食管胃底静脉曲张破裂出血患者按照随机数字表法分为两组。对照组40例给予无限制性液体复苏方法治疗,观察组40例给予限制性液体复苏和控制升压治疗。比较两组患者临床疗效、血气指标及并发症发生情况。结果观察组显效率为67.50%,显著高于对照组的42.50%(P<0.05);治疗24 h后,观察组血红蛋白、碱剩余明显高于对照组,血乳酸明显低于对照组(P<0.05);观察组再出血、多脏器功能障碍综合征(MODS)、急性呼吸窘迫综合征(ARDS)发生率均低于对照组(P<0.05)。结论限制性液体复苏和控制升压治疗肝硬化门脉高压食管胃底静脉曲张破裂出血疗效显著,降低了并发症发生率,改善了患者血气指标,值得临床重视。Objective To investigate the effect of limited fluid resuscitation and controlled boost of the treatment of esophageal gastric varices bleeding in patients with cirrhosis and portal hypertension.Methods Eighty patients with cirrhosis portal hypertension esophageal gastric varices bleeding were divided into two groups according to the random number table,40 cases in the control group were treated with unlimited liquid recovery method,the observation group was given limited fluid resuscitation and control boost therapy,the clinical efficacy,blood gas and complications were compared between the two groups.Results The efficiency of observation group was 42.50%,significantly higher than that of control group（P〈0.05）.After treatment with 24 h,the observation group was significantly higher than that of control group（P〈0.05）,and the incidence of bleeding,MODS and ARDS in observation group were lower than those in control group（P〈0.05）.Conclusion Limited fluid resuscitation and control of hypertension in patients with cirrhosis portal hypertension esophageal varices bleeding has significant curative effect,reduce the incidence of complications,improve the blood gas index.therefore,it is worthy of clinical attention.

关 键 词：肝硬化门脉高压 食管胃底静脉曲张破裂出血 限制性液体复苏 控制升压 

分 类 号：R575.21[医药卫生—消化系统]