内镜下套扎术辅助治疗对肝硬化食管静脉曲张出血患者血流动力学指标的影响  

The effect of endoscopic ligation as an auxiliary treatment on hemodynamic parameters in patients with esophageal variceal bleeding due to cirrhosis

作　　者：李海欣 吴柳拉 吴文娟 Li Haixin;Wu Liula;Wu Wenjuan(The Second Affiliated Hospital of Guangdong Medical University,Zhanjiang,Guangdong 524000,China)

机构地区：[1]广东医科大学附属第二医院,广东湛江524000

出　　处：《首都食品与医药》2024年第1期34-36,共3页Capital Food Medicine

摘　　要：目的观察内镜下套扎术辅助治疗对肝硬化食管静脉曲张出血患者血流动力学指标的影响。方法随机将2021年8月-2023年4月期间广东医科大学附属第二医院收治的肝硬化食管静脉曲张出血患者76例分为两组,每组各38例。两组均给予对症治疗,对照组给予奥美拉唑和生长抑素治疗,连续治疗7d,在此基础上,观察组给予内镜下套扎术辅助治疗,每1-2周进行1次套扎治疗,直至曲张静脉消失,治疗后进行为期12周的跟踪随访。比较两组临床指标、血流动力学指标、血清学指标及再出血情况。结果与对照组相比,观察组止血时间、住院时间短,输血量少(P<0.05);治疗后,两组VPV、QPV、DPV均降低,且观察组VPV、QPV降低幅度更显著(P<0.05);治疗后,两组MTL、GAS水平均降低,且观察组降低幅度更显著(P<0.05);与对照组相比,观察组的再出血率更低(P<0.05)。结论内镜下套扎术辅助治疗可改善肝硬化食管静脉曲张出血患者门静脉血流动力学,调节胃肠激素,缩短止血时间,减少输血量,发挥良好辅助止血作用。Objective To observe the effect of endoscopic ligation as an auxiliary treatment on hemodynamic parameters in patients with esophageal variceal bleeding due to cirrhosis.Method 76 patients with liver cirrhosis and esophageal variceal bleeding admitted to the hospital from August 2021 to April 2023 were randomly divided into two groups,with 38 patients in each group.Both groups were given symptomatic treatment,while the control group received omeprazole and somatostatin treatment for 7 consecutive days.On this basis,the observation group received endoscopic ligation as an auxiliary treatment,with ligation treatment performed every 1-2 weeks until the varicose vein disappeared.After treatment,a follow-up period of 12 weeks was conducted.Compare two groups of clinical indicators,hemodynamic indicators,serum indicators,and rebleeding status.Results Compared with the control group,the observation group had shorter hemostasis time,shorter hospitalization time,and less blood transfusion volume(P<0.05);after treatment,the VPV,QPV,and DPV of both groups decreased,and the VPV and QPV of the observation group decreased more significantly(P<0.05);after treatment,the levels of MTL and GAS in both groups decreased,and the observation group showed a more significant decrease(P<0.05);compared with the control group,the observation group had a lower rate of rebleeding(P<0.05).Conclusion Endoscopic ligation as an auxiliary treatment can improve portal vein hemodynamics,regulate gastrointestinal hormones,shorten hemostasis time,reduce blood transfusion volume,and play a good auxiliary hemostatic role in patients with esophageal variceal bleeding caused by cirrhosis.

关 键 词：肝硬化 食管静脉曲张出血 内镜下套扎术 血流动力学 

分 类 号：R657.31[医药卫生—外科学]