内镜下硬化剂联合组织胶治疗食管-胃底静脉曲张破裂出血的效果及对PLT、PT的影响  

Effect of Endoscopic Sclerosing Agent Combined with Tissue Glue in the Treatment of Esophagogas-tric Fundal Varices Rhexis Hemorrhage and Its Influence on PLT and PT

作　　者：朱文耘 ZHU Wenyun(People's Hospital of Ruijin City,Jiangxi Province,Ruijin 342500,China)

机构地区：[1]江西省瑞金市人民医院,江西瑞金342500

出　　处：《中国医学创新》2023年第25期29-33,共5页Medical Innovation of China

摘　　要：目的:探讨内镜下硬化剂联合组织胶治疗食管-胃底静脉曲张破裂出血的效果及对血小板计数(PLT)、凝血酶原时间(PT)的影响。方法:选取2019年10月—2021年7月瑞金市人民医院收治的68例食管-胃底静脉曲张破裂出血患者作为样本对象,以随机数字表法分为对照组和观察组,各34例。对照组采用内镜下硬化剂注射治疗,观察组给予内镜下硬化剂联合组织胶治疗。对比两组止血成功率、静脉曲张治疗效果、内毒素及一氧化氮(NO)水平、凝血指标和预后。结果:观察组止血成功率明显高于对照组(P<0.05);观察组静脉曲张总有效率明显高于对照组(P<0.05);治疗后,观察组血浆内毒素、NO水平均低于对照组(P<0.05);与对照组相比,治疗后观察组D-二聚体(D-D)、PLT均较高,PT、活化部分凝血活酶时间(APTT)均较短(P<0.05);两组再出血率、并发症发生率、院内死亡率对比,差异均无统计学意义(P>0.05)。结论:内镜下硬化剂联合组织胶治疗食管-胃底静脉曲张破裂出血的效果确切,能够缓解静脉曲张症状,改善凝血功能,预后良好。Objective:To investigate the effect of endoscopic sclerosing agent combined with tissue glue in the treatment of esophago-gas-tric fundal varices rhexis hemorrhage and its influence on platelet count(PLT),prothrombin time(PT).Method:A total of 68 patients with esophago-gas-tric fundal varices rhexis hemorrhage treated in People's Hospital of Ruijin City from October 2019 to July 2021 were selected as sample objects and divided into control group and observation group according to random number table method,with 34 cases in each group.The control group was treated with endoscopic sclerosing agent injection,and the observation group was treated with endoscopic sclerosing agent combined with tissue glue.The success rate of hemostasis,treatment effect of varicose veins,levels of endotoxin and nitric oxide(NO),coagulation indexes and prognosis were compared between the two groups.Result:The success rate of hemostasis in observation group was significantly higher than that in control group(P<0.05).The total effective rate of fundal varices in the observation group was significantly higher than that in the control group(P<0.05).After treatment,plasma endotoxin and NO levels in observation group were lower than those in control group(P<0.05).Compared with the control group,after treatment,the D-dimer(D-D)and PLT of observation group were higher,and the PT and activated partial thromboplastin time(APTT)of observation group were shorter(P<0.05).There were no significant differences in rebleeding rate,complication rate and in-hospital mortality between the two groups(P>0.05).Conclusion:Endoscopic sclerosing agent combined with tissue glue is effective in the treatment of esophago-gas-tric fundal varices rhexis hemorrhage,which can alleviate the symptoms of varicose vein,improve coagulation function and have a good prognosis.

关 键 词：内镜 硬化剂 组织胶 食管-胃底静脉曲张破裂出血 凝血 

分 类 号：R575.2[医药卫生—消化系统]