生长抑素联合普萘洛尔预防食管胃底静脉曲张内镜治疗术后早期再出血的疗效分析  

Efficacy analysis of somatostatin combined with propranolol in preventing early re-bleeding after endoscopic treatment of esophageal and gastric varices

作　　者：李恒 黄柳清 LI Heng;HUANG Liu-qing(Affiliated Hospital of Guangdong Medical University,Zhanjiang 524002,China)

机构地区：[1]广东医科大学附属医院,524002

出　　处：《中国实用医药》2021年第10期14-17,共4页China Practical Medicine

摘　　要：目的探讨生长抑素联合普萘洛尔预防食管胃底静脉曲张内镜治疗术后早期再出血的疗效。方法 49例肝硬化并食管胃底静脉曲张破裂出血患者,随机分为试验组(25例)和对照组(24例)。两组患者均行内镜下食管曲张静脉套扎术,及(或)内镜下胃底静脉曲张组织胶注射术。试验组患者术后给予生长抑素联合普萘洛尔治疗,对照组患者术后给予生长抑素治疗。对比两组患者术前及术后1个月门静脉宽度、门静脉流速;术后1个月内再出血发生情况;用药后不良反应发生情况。结果术后1个月,试验组患者门静脉宽度(1.17±0.09)cm低于本组术前的(1.24±0.13)cm,差异有统计学意义(P<0.05);对照组患者门静脉宽度于本组术前对比差异无统计学意义(P>0.05)。术后1个月,两组患者门静脉流速与本组术前对比差异均无统计学意义(P>0.05)。试验组患者术后1个月内再出血发生率4.00%低于对照组的25.00%,差异具有统计学意义(P<0.05)。两组患者乏力、恶心发生率对比差异无统计学意义(P>0.05);两组患者均未出现心悸、气促;试验组患者腹痛、腹胀发生率4.00%低于对照组的29.17%,差异具有统计学意义(P<0.05);试验组不良反应总发生率为28.00%,与对照组的37.50%对比差异无统计学意义(P>0.05)。结论生长抑素联合普萘洛尔能有效预防食管胃底静脉曲张内镜治疗术后早期再出血,减轻门静脉高压,减少腹痛、腹胀不良反应的发生。Objective To discuss the efficacy of somatostatin combined with propranolol in preventing early re-bleeding after endoscopic treatment of esophageal and gastric varices. Methods A total of 49 cases of liver cirrhosis complicated with esophageal gastric variceal bleeding were randomly divided into experimental group(25 cases) and control group(24 cases). Both groups underwent endoscopic esophageal varices ligation and/or endoscopic gastric varices tissue glue injection. Patients in the experimental group were treated with somatostatin combined with propranolol after operation, and patients in the control group were treated with somatostatin after operation. The portal vein width and portal vein flow rate before operation and 1 month after the operation, occurrence of re-bleeding within 1 month after the operation, and occurrence of adverse reactions after the medication were compared between the two groups. Results 1 month after the operation, the portal vein width(1.17±0.09) cm of the experimental group was lower than(1.24±0.13) cm before operation, and the difference was statistically significant(P<0.05);there was no statistically significant difference in portal vein width compared with that before operation in the control group(P>0.05). 1 month after the operation, there was no statistically significant difference in portal vein flow rate in the two groups compared with those before operation(P>0.05). The rebleeding rate at 1 month after the operation 4.00% of the experimental group was lower than 25.00% of the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in incidence of fatigue and nausea between the two groups(P>0.05). There was no palpitation or shortness of breath in the two groups. The incidence of abdominal pain and distension 4.00% of the experimental group was lower than 29.17% of the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions of the experimental group was 28.

关 键 词：生长抑素 普萘洛尔 预防 食管胃底静脉曲张内镜治疗术后 早期再出血 

分 类 号：R657.3[医药卫生—外科学]