内镜下曲张静脉套扎联合生长抑素治疗肝硬化食管静脉曲张破裂出血的有效性和安全性探讨  

Efficacy and safety of endoscopic variceal ligation combined with somatostatin in the treatment of esophageal varices bleeding with liver cirrhosis

作　　者：王伟[1] 魏丽娜[1] 孔桂香[1] 张燕宁[1] WANG Wei;WEI Li＇na;KONG Guixiang;ZHANG Yanning(Department of Gastroenterology,the Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院消化科,甘肃兰州730030

出　　处：《中国现代医生》2018年第25期45-47,共3页China Modern Doctor

摘　　要：目的探讨肝硬化食管胃底静脉曲张破裂出血采用内镜下曲张静脉套扎联合生长抑素治疗的临床效果和安全性。方法选取2013年1月～2017年12月在我院接受治疗的460例肝硬化食管胃底静脉曲张破裂出血患者作为研究对象,采用随机数字表法分为对照组生长抑素治疗)与观察组(内镜下曲张静脉套扎联合生长抑素治疗治疗),每组230例。对比两组患者临床治疗后近期和远期的出血情况以及治疗后出现不良反应的情况。结果试验组患者的1个月再出血率(5.22%)、3个月再出血率(3.48%)、止血率(74.78%)以及死亡率(5.65%)与对照组患者的1个月再出血率(30.00%)、3个月再出血率(35.22%)、止血率(46.65%)以及死亡率(25.22%)相比,差异具有统计学意义(P<0.05);试验组患者不良反应发生率(6.52%)明显低于对照组(33.04%),差异具有统计学意义(P<0.05)。结论肝硬化食管静脉曲张破裂出血采用内镜下曲张静脉套扎和生长抑素联合治疗可以有效控制出血情况,降低再出血的发生,提高静脉曲张消失率,改善患者的生活质量。Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation combined with so- matostatin in the diagnosis of esophageal varices bleeding with liver cirrhosis. Methods A total of 460 cirrhotic esophageal and gastric varices bleeding patients who were treated in our hospital from January 2013 to December 2017 were selected as the study subjects. They were divided into control group treated with somatostatin treatment and obser- vation group treated with endoscopic variceal ligation combined with somatostatin by random number table method, with 230 patients in each group. The recent and long-term bleeding and the occurrence of adverse reactions af, er clinical treatment in the two groups were compared and analyzed. Results The one-month rebleeding rate （5.22%）, three-month rebleeding rate （3.48%）, hemostasis rate （74.78%）, and mortality （5.65%） in the experimental group were significantly different from the one-month bleeding rate （30.00%）,three-month rebleeding rate （35.22%）,hemostasis rate （46.65%） and mortality rate（25.22%）, and the difference was statistically significant （P〈0.05）. The incidence of adverse reactions （6.52%） was significantly lower than that in the control group（33.04%）, and the difference was statistically significant （P〈0.05）. Conclusion Endoscopic variceal ligation and somatostatin combined therapy for the treatment of esophageal varices bleeding with liver cirrhosis can effectively control bleeding, reduce the occurrence of rebleeding, improve the disappearance of varicose veins, and improve the quality of life of patients.

关 键 词：肝硬化 食管胃底静脉曲张破裂出血 内镜下曲张静脉套扎 生长抑素 联合疗效 

分 类 号：R575.2[医药卫生—消化系统]