食管静脉套扎联合生长抑素治疗肝硬化并发食管静脉曲张破裂出血的临床效果分析  

Clinical effect analysis of esophageal vein ligation combined with somatostatin in the treatment of esophageal variceal rupture and bleeding with cirrhosis

作　　者：朱海洋[1] 高红伟[1] 孙会卿[1] ZHU Hai-yang;GAO Hong-wei;SUN Hui-qing(Department of Gastroenterology,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院消化内科,郑州450052

出　　处：《医药论坛杂志》2022年第8期59-62,共4页Journal of Medical Forum

基　　金：2020年河南省医学科技攻关计划省部项目(SB202002077)。

摘　　要：目的 分析肝硬化并发食管静脉曲张破裂出血患者联合使用食管静脉套扎与生长抑素的作用。方法 选取2020年1月—2021年12月郑州大学第五附属医院消化内科接受治疗的肝硬化并发食管静脉曲张破裂出血患者64例,按治疗方法不同,将常规支持联合生长抑素治疗的32例作为常规组,将常规组基础上加用食管静脉套扎治疗的32例作为观察组,比较两组患者治疗效果、临床指标、肝静脉压力梯度(HVPG)水平、不良反应发生率、再出血发生率。结果 观察组治疗总有效率100.00%,高于常规组(90.6%),组间差异对比有统计学意义(P<0.05);观察组输血量、止血时间及住院时间分别为(1.7±1.0)U、(1.3±0.4)h及(20.4±3.5)d,均低于常规组,观察组费用(13 125.6±2 333.4)元,高于常规组,P<0.05;治疗前两组HVPG、RBC及Hb水平差异无统计学意义(P>0.05);治疗后观察组HVPG水平低于常规组,RBC和Hb水平高于常规组,差异有统计学意义(P<0.05);观察组不良反应发生率(15.6%)与常规组(12.5%)比较无统计学意义(P>0.05);术后随访12个月,观察组再出血总发生率为15.6%,明显低于对照组(71.9%)(P<0.05)。结论 食管静脉套扎联合生长抑素治疗肝硬化并发食管静脉破裂出血有显著效果,可以考虑积极推广。Objective To analyze the effect of esophageal vein ligation combined with somatostatin in patients with cirrhosis complicated with esophageal variceal rupture and bleeding.Methods Selection in January 2020-December 2021 the fifth affiliated hospital of zhengzhou university digestive internal medicine for treatment of liver cirrhosis complicated with esophageal varices rupture hemorrhage, 64 cases of patients, according to the treatment is different, will support joint somatostatin conventional treatment of 32 cases as normal group, will be based on conventional group and 32 cases with esophageal vein ligation treatment as observation group, The treatment effect, clinical indicators, HVPG level, incidence of adverse reactions and incidence of rebleeding were compared between the two groups.Results The total effective rate of observation group was 100.00%,which was higher than that of conventional group(90.6%),P<0.05;The amount of blood transfusion, hemostatic time and hospital stay in the observation group were(1.7±1.0) U,(1.3±0.4) h and(20.4±3.5) d, respectively, lower than those in the conventional group.The cost of the observation group was(13125.6±2333.4) yuan, higher than that in the conventional group, P<0.05.Before treatment, there were no significant differences in HVPG,RBC and Hb levels between the two groups(P>0.05).After treatment, HVPG level in observation group was lower than that in conventional group, RBC and Hb levels were higher than that in conventional group, the difference was statistically significant(P<0.05).In the observation group, there were 1 case of fever, 3 cases of abdominal distension and 1 case of nausea, and the incidence of adverse reactions was 15.6%.In the conventional group, there were 3 cases of loose stools and 1 case of palpitation, and the incidence of adverse reactions was 12.5%,P>0.05.After 12 months of follow-up, the total incidence of rebleeding in the observation group was 15.6%,significantly lower than that in the control group(71.9%,P<0.05).Conclusion Esophageal v

关 键 词：食管静脉套扎 生长抑素 联合治疗 肝硬化 食管静脉曲张破裂出血 

分 类 号：R571[医药卫生—消化系统]