奥曲肽联合内镜下套扎术治疗肝硬化合并食管胃底静脉曲张破裂出血患者的效果  

Effects of Octreotide combined with endoscopic ligation in treatment of patients with cirrhosis complicated with bleeding caused by rupture of esophageal and gastric varices

作　　者：江文龙 JIANG Wenlong(Department of Gastroenterology of Duchang County People’s Hospital,Jiujiang 332600 Jiangxi,China)

机构地区：[1]都昌县人民医院消化内科,江西九江332600

出　　处：《中国民康医学》2023年第24期15-18,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察奥曲肽联合内镜下套扎术治疗肝硬化合并食管胃底静脉曲张破裂出血患者的效果。方法:选取2021年4月至2023年4月该院收治的70例肝硬化合并食管胃底静脉曲张破裂出血患者进行前瞻性研究,按随机数字表法将其分为对照组与观察组各35例,对照组给予内镜下套扎术治疗,观察组在对照组基础上联合奥曲肽治疗。比较两组治疗前后门静脉血流动力学指标[门静脉内径(PVD)、门静脉压(PVP)、门静脉血流量(PVF)、门静脉血流速度(PVV)]水平、凝血功能指标[纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血时间(TT)、活化部分凝血酶原时间(APTT)]水平,临床疗效,再出血率,以及并发症/不良反应发生率。结果:治疗后,两组PVD、PVP、PVF、PVV水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组FIB水平均高于治疗前,且观察组高于对照组,两组PT、TT、APTT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为97.14%(34/35),高于对照组的77.14%(27/35),差异有统计学意义(P<0.05);治疗后1、3、6个月,观察组再出血率均低于对照组,差异有统计学意义(P<0.05);两组并发症/不良反应发生率比较,差异无统计学意义(P>0.05)。结论:奥曲肽联合内镜下套扎术治疗肝硬化合并食管胃底静脉曲张破裂出血患者可提高治疗总有效率,改善凝血功能指标水平,降低门静脉血流动力学指标水平和再出血率,其效果优于单纯内镜下套扎术治疗。Objective:To observe effects of Octreotide combined with endoscopic ligation in treatment of patients with cirrhosis complicated with bleeding caused by rupture of esophageal and gastric varices.Methods:A prospective study was conducted on 70 patients with cirrhosis complicated with bleeding caused by rupture of esophageal and gastric varices admitted to the hospital from April 2021 to April 2023.They were divided into control group and observation group according to the random number table method,35 cases in each group.The control group was treated with endoscopic ligation,while the observation group was treated with Octreotide on the basis of that of the control group.The levels of portal vein hemodynamic indexes[portal vein diameter(PVD),portal vein pressure(PVP),portal vein blood flow(PVF),portal vein blood flow velocity(PVV)],the coagulation function index levels[fibrinogen(FIB),prothrombin time(PT),coagulation time(TT),activated partial prothrombin time(APTT)],the clinical efficacy,the rebleeding rate,and the incidence of complications/adverse reactions were compared between the two groups before and after the treatment.Results:After the treatment,the levels of PVD,PVP,PVF and PVV in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The FIB levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;the levels of PT,TT and APTT in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 97.14%(34/35),which was higher than 77.14%(27/35)in the control group,and the difference was statistically significant(P<0.05).1,3 and 6 months after the treatment,the rebleeding rates in the observati

关 键 词：肝硬化 食管胃底静脉曲张破裂 出血 奥曲肽 内镜下套扎术 门静脉血流动力学 凝血功能 

分 类 号：R654.4[医药卫生—外科学]