内镜套扎联合中西药治疗肝硬化食管静脉曲张破裂出血的临床研究  

The clinical effect of endoscopic ligation combined with traditional Chinese and Western medicines on liver cirrhosis esophagogastric variceal bleeding

作　　者：刘晓东[1] 回丽妹[2] 王建华[1] 卜保国 李彤中[3] LIU Xiao-dong;HUI Li-mei;WANG Jian-hua;Bao-guo;Tong-zhong(Department of Gastroenterology,Affiliated Hospital of Hebei University of Engineering,Handan 056000,China;Department of Obstetrics,Affiliated Hospital of Hebei University of Engineering,Handan 056000,China;Department of Rehabilitation,Affiliated Hospital of Hebei University of Engineering,Handan 056000,China)

机构地区：[1]河北工程大学附属医院消化科,河北邯郸056000 [2]河北工程大学附属医院产科,河北邯郸056000 [3]河北工程大学附属医院康复科,河北邯郸056000

出　　处：《中国中西医结合消化杂志》2019年第6期436-440,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：邯郸市科技局项目(No:1223108086-10)

摘　　要：[目的]探讨内镜套扎联合中西药治疗肝硬化食管静脉曲张破裂出血(EVB)的临床疗效。[方法]选取2010年1月~2015年1月我院收治的90例肝硬化EVB患者,按照随机数字表法分为3组,A组为单纯西药组,B组为内镜下食管静脉曲张套扎术(EVL)联合西药组,C组为EVL联合中西药组,观察2组患者止血效果、血流动力学及肝纤维化变化、曲张静脉消失率与不良反应。[结果]EVL术前止血率C组明显高于A、B组,B、C 2组EVL术后止血率明显高于A组,早期再出血率C组明显低于A、B组(P<0.05),而A、B组EVL术前止血率及3组迟发再出血率、死亡率比较差异无统计学意义;治疗后C组门静脉主干血管及Ⅲ型前胶原氨基末端肽均明显低于A、B组(P<0.05);C组曲张静脉消失率明显高于A、B组(P<0.05);3组不良反应发生率比较差异无统计学意义。[结论]EVL联合中西药治疗肝硬化EVB患者止血效果显著,提高曲张静脉消失率,无显著不良反应。[Objective]To investigate the clinical effect of endoscopic ligation combined with traditional Chinese and Western Medicines on liver cirrhosis esophagogastric variceal bleeding(EVB).[Methods]90 patients with liver cirrhosis EVB admitted to our hospital from January 2010 to January 2015 were divided into three groups according to random number table method,group A was pure Western medicine group,group B was endoscopic variceal ligation(EVL)combined with Western medicine group,and group C was EVL combined with Chinese and Western Medicines group,the hemostatic effect,hemodynamics,liver fibrosis,the disappearance rate of varicose veins,and adverse reactions were observed.[Results]The preoperative hemostasis rate of EVL in group C was significantly higher than that in groups A and B,the postoperative hemostasis rate of EVL in groups B and C after EVL was significantly higher than that in group A,the rate of early rebleeding in group C was significantly lower than that in groups A and B(P<0.05),there was no significant difference in preoperative hemostasis rate between group A and group B,and delayed rebleeding rate and mortality rate between the three groups(P>0.05);after treatment,the main portal vein vessels and levels of procollagen type III aminoterminal peptide in group C were significantly lower than those in groups A and B(P<0.05);the disappearance rate of varicose veins in group C was significantly higher than that in groups A and B(P<0.05);there was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).[Conclusion]Hemostatic effect of EVL combined with traditional Chinese and Western medicines in the treatment of liver cirrhosis EVB patients is remarkable,it can improve the rate of varicose vein disappearance rate,without significant adverse reactions.

关 键 词：内镜套扎 奥曲肽 中药 肝硬化 食管静脉曲张破裂出血 

分 类 号：R575.2[医药卫生—消化系统]