卡维地洛联合ESVD治疗食管胃静脉曲张出血的研究  

Study on Carvedilol Combined with ESVD in the Treatment of Esophagogastric Variceal Bleeding

作　　者：黄兰[1] 李江涛[1] 李艳艳[1] 曹细妹 HUANG Lan;LI Jiangtao;LI Yanyan;CAO Ximei(Department of Gastroenterology,Jiujiang NO.1 People's Hospital,Jiujiang 332000,China;不详)

机构地区：[1]九江市第一人民医院消化内科,江西九江332000

出　　处：《中国医学创新》2024年第12期88-92,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202211765)。

摘　　要：目的:探究卡维地洛联合内镜下食管胃静脉曲张精准断流术(ESVD)治疗食管胃静脉曲张出血的效果。方法:按随机数字表法将2022年1月—2023年1月九江市第一人民医院收治的82例肝硬化食管胃静脉曲张出血患者分为研究组和对照组,各41例。对照组予以ESVD联合普萘洛尔治疗,研究组予以ESVD联合卡维地洛治疗。比较两组治疗效果;观察患者再出血、再次内镜治疗和不良事件发生情况;比较两组治疗前和治疗1个月后的检查结果[肝静脉压力梯度(HVPG)、静脉曲张截断直径定量大小]。结果:研究组总有效率显著高于对照组(P<0.05);研究组再出血率显著低于对照组(P<0.05);两组再次接受内镜治疗率和不良事件总发生率比较,差异均无统计学意义(P>0.05);治疗1个月后,两组HVPG和静脉曲张截断直径定量大小均较治疗前显著下降,且研究组均低于对照组(P<0.05)。结论:卡维地洛联合ESVD治疗食管胃静脉曲张出血能够有效增加止血成功的概率,降低再出血率。Objective:To explore the effect of Carvedilol combined with endoscopic selective varices devascularization(ESVD)in the treatment of esophagogastric variceal bleeding.Method:A total of 82 patients with cirrhosis esophagogastric variceal bleeding treated in Jiujiang NO.1 People's Hospital from January 2022 to January 2023 were divided into study group and control group according to random number table method,with 41 cases in each group.The control group was treated with ESVD combined with Propranolol,and the study group was treated with ESVD combined with Carvedilol.The therapeutic effect of the two groups was compared.The re-bleeding,re-endoscopic treatment and adverse events of patients were observed.The results of examination[hepatic venous pressure gradient(HVPG),quantitative size of varicose vein cutoff diameter]before treatment and after 1 month of treatment were compared between the two groups.Result:The total effective rate of the study group was significantly higher than that of the control group(P<0.05).The re-bleeding rate of the study group was significantly lower than that of the control group(P<0.05).There were no significant differences in the rate of reendoscopic treatment and the total incidence of adverse events between the two groups(P>0.05).After 1 month of treatment,the HVPG and quantitative size of varicose vein cutoff diameter in both groups were significantly decreased compared with those before treatment,and those in the study group were lower than those in the control group(P<0.05).Conclusion:Carvedilol combined with ESVD in the treatment of esophagogastric variceal bleeding can effectively increase the probability of successful hemostasis,reduce the rate of re-bleeding.

关 键 词：卡维地洛 内镜下食管胃静脉曲张精准断流术 普萘洛尔 食管胃静脉曲张出血 

分 类 号：R575.2[医药卫生—消化系统]