内镜套扎术联合卡维地洛预防食管静脉曲张再出血的效果  

Efficacy of endoscopic ligation combined with Carvedilol for prevention of esophageal varices rebleeding

作　　者：原姗姗[1] 张欣[1] 张彦亭[1] 杨振威[1] 唐海灵[1] 李怡君 庄坤[1] YUAN Shanshan;ZHANG Xin;ZHANG Yanting;YANG Zhenwei;TANG Hailing;LI Yijun;ZHUANG Kun(Department of Gastroenterology,Xi′an Central Hospital,Shaanxi Province,Xi′an 710003,China)

机构地区：[1]陕西省西安市中心医院消化科,陕西西安710003

出　　处：《中国医药导报》2018年第35期134-137,145,共5页China Medical Herald

基　　金：陕西省西安市科技计划项目[2017113SF/YX007(10)]

摘　　要：目的观察内镜套扎术联合卡维地洛预防食管静脉曲张再出血的疗效。方法选择2016年10月～2017年6月西安市中心医院肝硬化食管静脉曲张破裂出血患者126例,根据随机数字表法分为实验组、对照A组、对照B组,每组各42例。对照A组单纯采取内镜套扎术治疗,对照B组采取内镜套扎术联合普萘洛尔治疗,实验组采取内镜套扎术联合卡维地洛治疗。术后实施1年随访,比较三组临床效果、再出血率与治疗前后肝功能ChildPugh分级、食管静脉曲张程度分级、脾脏硬度。结果术后1年实验组总有效率较对照A组及对照B组高(P <0.05);术后1年实验组再出血率较对照A组及对照B组低(P <0.05);术后1年实验组肝功能Child-Pugh分级较治疗前改善,且优于对照A组及对照B组(P <0.05);术后1年三组食管静脉曲张程度分级均较治疗前减轻,且实验组优于对照A组及对照B组(P <0.05);术后1年三组脾脏硬度均较治疗前降低,且实验组较对照A组及对照B组低(P <0.05)。结论肝硬化食管静脉曲张破裂出血患者予以内镜套扎联合卡维地洛治疗可增强疗效,减少再出血,改善患者肝功能及食管静脉曲张程度,降低脾脏硬度。Objective To observe the efficacy of endoscopic ligation combined with Carvedilol in the prevention of esophageal varices rebleeding.Methods A total of126patients with cirrhosis of esophageal varices treated in Xi'an Central Hospital from October2016to June2017were enrolled.The patients were divided into experimental group,control group A and control group B by random number table method with42cases in each group.The control group A was treated with endoscopic ligation alone.The control group B was treated with endoscopic ligation combined with Propranolol.The experimental group was treated with endoscopic ligation combined with Carvedilol.Oneyear follow-up was performed after operation.Clinical effect,rebleeding rate,Child-Pugh classification of liver function,esophageal varices classification,and spleen hardness were compared before and after treatment.Results The total effective rate of the experimental group was higher than that of the control group A and the control group B(P<0.05).The rebleeding rate in the experimental group was lower than that in the control group A and the control group B(P<0.05).One year postoperation,the Child-Pugh classification of liver function in the experimental group was better than that before treatment,and it was better than that in the control group A and the control group B(P<0.05).The grades of esophageal varices in the three groups all improved than those before treatment,and the experimental group was superior to the control group A and the control group B(P<0.05).The spleen hardness of the three groups were lower than those before treatment,and the experimental group was lower than that in the control group A and the control group B(P<0.05).Conclusion Endoscopic ligation combined with Carvedilol treating patients with cirrhosis of esophageal varices can enhance the efficacy,reduce rebleeding,improve liver function and esophageal varices,and reduce spleen stiffness.

关 键 词：肝硬化 食管静脉曲张 破裂出血 内镜套扎 卡维地洛 再出血率 食管静脉曲张程度 

分 类 号：R571[医药卫生—消化系统]