改良三腔二囊管联合内镜硬化剂注射治疗食管胃底静脉曲张破裂大出血的临床效果分析  

Clinical Effect Analysis of Modified Three-cavity Two-capsule Tube Combined with Endoscopic Sclerotherapy in the Treatment of Massive Hemorrhage Caused by Esophageal and Gastric Varices Rupture

作　　者：陈河森[1] 索标[1] CHEN Hesen;SUO Biao(Department of Emergency,Xiamen Hospital of Traditional Chinese Medicine,Xiamen,Fujian Province,361009 China)

机构地区：[1]厦门市中医院急诊科,福建厦门361009

出　　处：《中外医疗》2023年第6期18-21,26,共5页China & Foreign Medical Treatment

摘　　要：目的 观察食管胃底静脉曲张破裂大出血患者采用改良三腔二囊管与内镜硬化剂注射联合治疗的效果。方法 方便选取2020年1月—2021年10月厦门市中医院急诊科收治的食管胃底静脉曲张破裂大出血患者54例为研究对象,依照治疗方法分为两组,对照组(n=27,内镜硬化剂注射治疗)与观察组(n=27,在对照组基础上联合应用改良三腔二囊管压迫止血),比较两组治疗后不同时间的止血效果、治疗效果以及不良反应发生情况。结果 治疗后30、60、90 min观察组患者止血成功率均高于对照组,差异有统计学意义(χ^(2)=6.033、5.082、4.964,P<0.05),治疗5 h后两组患者止血成功率比较,差异无统计学意义(χ^(2)=3.669,P>0.05)。观察组临床总有效率(96.30%)显著高于对照组(66.67%),差异有统计学意义(χ^(2)=7.855,P<0.05)。观察组患者胸痛及胸闷发生率(7.41%、7.41%)低于对照组(33.33%、33.33%),差异有统计学意义(χ^(2)=5.594、5.594,P<0.05)。结论 食管胃底静脉曲张破裂大出血患者采用改良三腔二囊管与内镜硬化剂注射联合治疗可取得理想的效果,止血有效率更高且止血效果更佳,还有助于减少用药后不良反应。Objective To observe the effect of combined treatment with modified three-cavity two-capsule tube and endoscopic sclerotherapy for massive hemorrhage caused by esophageal and gastric varices rupture.Methods 54 patients with esophageal and gastric variceal bleeding admitted to the Emergency Department of Xiamen Traditional Chinese Medicine Hospital from January 2020 to October 2021 were conveniently selected as the research subjects.They were divided into two groups according to the treatment methods:the control group(n=27,endoscopic sclerotherapy injection treatment)and the observation group(n=27,combined with improved three cavity two capsule tube compression hemostasis on the basis of the control group).The hemostatic effects of the two groups at different times after treatment,treatment effectiveness and occurrence of adverse reactions were compared.Results The success rate of hemostasis in the observation group was higher than that in the control group at 30,60,and 90 minutes after treatment,and the difference was statistically significant(χ^(2)=6.033,5.082,4.964,P<0.05),there was no statistically significant difference in the success rate of hemostasis between the two groups of patients after 5 hours of treatment(χ^(2)=3.669,P>0.05).The total clinical effective rate of the observation group(96.30%)was significantly higher than that of the control group(66.67%),and the difference was statistically significant(χ^(2)=7.855,P<0.05).The incidence of chest pain and tightness in the observation group(7.41%,7.41%)was lower than that in the control group(33.33%,33.33%),and the difference was statistically significant(χ^(2)=5.594,5.594,P<0.05).Conclusion The combination treatment of modified three lumen two balloon catheter and endoscopic sclerotherapy injection can achieve ideal results in patients with massive bleeding caused by esophageal and gastric varices rupture.The hemostatic efficiency is higher and the hemostatic effect is better,and it also helps to reduce adverse reactions after medication.

关 键 词：食管胃底静脉曲张破裂大出血 改良三腔二囊管 内镜硬化剂注射治疗 止血效果 不良反应 

分 类 号：R5[医药卫生—内科学]