聚桂醇联合人体组织黏合剂对胃底静脉曲张出血病人门静脉血流动力学及血清应激激素影响  

Effects of polycinol and human tissue adhesive on portal vein hemodynamics and serum stress hormones in patients with gastric variceal bleeding

作　　者：孟庆顺 杨村 李洪运[1] 吕鹏[1] MENG Qingshun;YANG Cun;LI Hongyun;LYU Peng(Department of Gastroenterology,The First People's Hospital of Jining,Jining,Shandong 272011,China)

机构地区：[1]济宁市第一人民医院消化科,山东济宁272011

出　　处：《安徽医药》2021年第8期1562-1566,共5页Anhui Medical and Pharmaceutical Journal

基　　金：山东省医药卫生科技发展计划项目(2017WS826)。

摘　　要：目的分析聚桂醇联合人体组织黏合剂对胃底静脉曲张出血(EGVB)病人门静脉血流动力学及血清应激激素影响。方法选取2014年10月至2018年10月于济宁市第一人民医院接受治疗的肝硬化EGVB病人84例,随机数字表法将病人分为对照组碘油-组织黏合剂-碘油法止血,观察组聚桂醇-组织黏合剂-聚桂醇止血;观察两组临床疗效、止血效果、门静脉血流动力学、血清应激激素含量及并发症情况。结果观察组总有效率为97.62%,高于对照组的80.95%(P<0.05);观察组迟发性再出血16.67%,低于对照组的35.71%(P<0.05);两组病人成功止血及早期再出血差异无统计学意义(P>0.05);治疗后观察组脾静脉及门静脉血管内径较治疗前降低,对照组脾脏厚度、脾静脉及门静脉血管内径较治疗前升高,差异有统计学意义(P<0.05);治疗后观察组血清皮质醇(Cor)、胃泌素(GAS)、肾上腺素(E)、去甲肾上腺激素(NE)及血管紧张素Ⅱ(AT-Ⅱ)含量均低于对照组(P<0.05)。结论聚桂醇联合人体组织黏合剂对EGVB病人疗效显著,可减轻病人应激反应程度,改善门静脉血流动力学,且临床应用安全性较高。Objective To analyze the effects of polycinol and human tissue adhesive on portal vein hemodynamics and serum stress hormones in patients with gastric fundus varices bleeding(EGVB).Methods Eighty-four patients with cirrhosis and EGVB who were treated in the First People’s Hospital of Jining from October 2014 to October 2018 were selected.The patients were assigned into the control group with the lipiodol-tissue adhesive-iodine method to stop bleeding and observation group with alcohol-tissue adhesive-polycinnol to stop bleeding by using a random number table method.The clinical efficacy,hemostatic effect,portal vein hemodynamics,serum stress hormone content and complications of patients were observed.Results The total effective rate in the observation group was 97.62%,which was higher than 80.95%in the control group(P<0.05).The delayed rebleeding in the observation group was 16.67%,which was lower than 35.71%in the control group(P<0.05).The patients in the two groups succeeded.There was no significant difference between hemostasis and early rebleeding(P>0.05).After treatment,the inner diameters of the splenic veins and portal veins in the observation group were lower than those before treatment.The spleen thickness,inner diameters of the splenic veins and portal veins in the control group were higher than before treatment.Difference was statistically significant(P<0.05).Serum levels of cortisol(Cor),gastrin(GAS),epinephrine(E),norepinephrine(NE)and angiotensinⅡ(AT-Ⅱ)in the observation group were lower than those in the control group after treatment(P<0.05).Conclusion Polycinol combined with human tissue adhesive has a significant effect on patients with EGVB.It can reduce the degree of stress response,improve portal vein hemodynamics,and has higher clinical safety.

关 键 词：食管和胃静脉曲张 胃底静脉曲张出血 组织黏合剂 聚桂醇 血流动力学 

分 类 号：R575.2[医药卫生—消化系统]