套扎联合硬化剂治疗肝硬化食管静脉曲张疗效观察  

Clinical observation of ligation combined with sclerosing agent in the treatment of cirrhotic esophageal varices

作　　者：倪猛[1] 樊宏伟[1] 郑喜胜[1] Ni Meng;Fan Hongivei;Zheng Xisheng(Nanyang Central Hospital,Nanyung 473000,Henan,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《临床心身疾病杂志》2019年第5期135-137,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨套扎联合硬化治疗肝硬化食管静脉曲张出血患者的临床效果.方法将81例肝硬化食管静脉曲张患者按随机数字表法分为研究组38例,对照组43例,均予以套扎手术治疗,研究组联合硬化剂治疗.统计分析术后两组患者曲张静脉消失率、术后1个月再出血率及术后1年并发症发生率、曲张静脉复发率;检测两组术后门静脉和脾静脉血流动力学情况,比较两组食管下段括约肌静息压、松弛压力、松弛率、松弛持续时间.结果术后研究组曲张静脉总消失率(84.2%)显著高于对照组(69.8%),门静脉和脾静脉血流速度显著快于对照组,血流量显著大于对照组,术后1年曲张静脉复发率(5.3%)显著低于对照组(20.9%)(P<0.05或0.01);术后1个月再出血率、并发症发生率及食管下段括约肌静息压、松弛压力、松弛率和松弛持续时间与对照组比较差异无统计学意义(P>0.05).结论套扎联合硬化剂治疗肝硬化食管静脉曲张患者临床疗效显著,有利于增加肝脏血供,对食管下段括约肌无明显影响,安全性高.Objective To investigate effect of ligation combined with sclerosing a- gent in the treatment of cirrhotic esophageal varices. Methods 81 cases of cir-rhotic esophageal varices were randomly divided into the the study group (n = 38) and the control group (n= 43). All were treated with ligation, and the study group was treated with sclerotherapy. The rate of varicose vein disappearance,the rate of rebleeding at 1 month after operation, the incidence of complica-tions at 1 year after operation, and the rate of varicose vein recurrence of the two groups were analyzed. Hemodynamics of portal vein and splenic vein after operation in both groups were detected. The resting pressure, relaxation pressure, relaxation rate and relaxation duration of the lower esophageal sphincters were compared between the two groups. Results The total vanishing rate of varicose veins in the study group was 84. 2%, which was significantly higher than that of the control group (69. 8%). The blood flow velocity of portal vein and splenic vein was significantly faster than that of the control group, and the blood flow was significantly higher than that of the control group. One year after surgery, the variceal recur-rence rate (5. 3%) was significantly lower than that of the control group (20. 9%)(P<0. 05 or 0. 01). One month after operation, there was no significant difference in rebleeding rate, complication rate,and resting pressure, relaxation pressure,relaxation rate and relaxation duration of the lower esophageal sphincter compared with the control group (P>0. 05). Conclusion The clinical effect of ligation combined with sclerotherapy for patients with cirrhosis and esophageal varices is significant, which is beneficial to increase blood supply to the liver, has no obvious effect on the lower esophageal sphincter, and has high safety.

关 键 词：肝硬化 食管静脉曲张 套扎手术 硬化剂 食管下段括约肌 临床效果 并发症 复发率 

分 类 号：R459.1[医药卫生—治疗学]