规律内镜下治疗对肝硬化食管胃底静脉曲张出血患者的影响  

Effect of Regular Endoscopic Therapy on Patients with Esophageal and Gastric Varices Bleeding in Cirrhotic Patients

作　　者：林丽平 王毅鸿 赖亚栋 LIN Liping;WANG Yihong;LAI Yadong(Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou 363000,China;不详)

机构地区：[1]福建医科大学附属漳州市医院,福建漳州363000

出　　处：《中外医学研究》2024年第15期142-145,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨规律内镜下治疗对肝硬化食管胃底静脉曲张出血(EGVB)患者的影响。方法:回顾性选取2021年6月—2023年3月福建医科大学附属漳州市医院收治的120例肝硬化EGVB患者。根据不同治疗方式将其分为观察组和对照组,各60例。对照组给予常规止血治疗,观察组给予规律内镜下治疗。比较两组治疗前、治疗1周后门静脉指标、胃肠激素及再出血情况。结果:治疗1周后,两组门静脉血流速度(PVV)、门静脉内径(PVD)、门静脉血流量(PVF)、门静脉压力(PVP)较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗1周后,两组胰高血糖素(GLC)、胃泌素(GAS)、胃动素(MTL)水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组再出血2例(3.33%),对照组再出血9例(15.00%),观察组再出血率低于对照组,差异有统计学意义(χ^(2)=4.904,P=0.027)。观察组再出血患者间隔时间为(4.43±0.56)个月,长于对照组的(2.51±0.46)个月,差异有统计学意义(t=5.167,P<0.05)。结论:肝硬化EGVB患者采用规律内镜下治疗,能改善门静脉血流动力学,调节胃肠激素水平,并且降低再出血率,延长再出血间隔时间。Objective:To explore the effect of regular endoscopic therapy on patients with esophageal and gastric varices bleeding(EGVB)in cirrhotic patients.Method:A total of 120 cirrhosis patients with EGVB admitted to Zhangzhou Hospital Affiliated to Fujian Medical University from June 2021 to March 2023 were retrospectively selected.According to different treatment methods,the patients were divided into observation group and control group,60 cases in each group.The control group was given routine hemostatic treatment,and the observation group was given regular endoscopic therapy.Portal vein indexes,gastrointestinal hormones before treatment and after 1 week of treatment and rebleeding condition were compared between the two groups.Result:After 1 week of treatment,the portal vein blood velocity(PVV),portal vein diameter(PVD),portal vein blood flow(PVF)and portal vein pressure(PVP)in two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After 1 week of treatment,the levels of glucagon(GLC),gastrin(GAS)and motilin(MTL)in two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were 2 cases of rebleeding in the observation group(3.33%)and 9 cases of rebleeding in the control group(15.00%).The rebleeding rate in the observation group was lower than that in the control group,the difference was statistically significant(χ^(2)=4.904,P=0.027).The interval time of rebleeding patients in the observation group was(4.43±0.56)months,which was longer than(2.51±0.46)months in the control group,the difference was statistically significant(t=5.167,P<0.05).Conclusion:Regular endoscopic therapy on EGVB in cirrhotic patients can improve portal vein hemodynamics,regulate gastrointestinal hormone levels,reduce the rate of rebleeding,and prolong the interval of rebleeding.

关 键 词：肝硬化 食管胃底静脉曲张出血 内镜 胃肠激素 门静脉 

分 类 号：R575.2[医药卫生—消化系统]