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分析  

Effect analysis of octreotide combined with endoscopic ligation in the treatment of patients with cirrhosis complicated with esophageal and gastric variceal bleeding

作　　者：倪景斌[1] 凤辉[1] 孙寅力 胡臻[1] NI Jing-bin;FENG Hui;SUN Yin-li(Department of Gastroenterology,Wuxi Second People's Hospital(Jiangnan University Affiliated Central Hospital),Wuxi 214002,China)

机构地区：[1]无锡市第二人民医院(江南大学附属中心医院)消化内科,214002

出　　处：《中国现代药物应用》2025年第3期88-91,共4页Chinese Journal of Modern Drug Application

基　　金：无锡市“双百”中青年医疗卫生拔尖人才资助计划(项目名称:HB2023028)。

摘　　要：目的探讨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110例肝硬化合并食管胃底静脉曲张破裂出血患者,其中55例单纯行内镜下套扎术治疗的患者作为单纯套扎组,55例行奥曲肽联合内镜下套扎术治疗的患者作为联合组。比较两组患者止血效果、术后症状消失时间和住院时间、门静脉血流动力学指标[门静脉主干内径(PVD)、门静脉血流量(PVF)、门静脉血流速度(PVV)]、不良事件发生情况、预后情况。结果联合组治疗总有效率(98.18%)显著高于单纯套扎组(83.64%)(P<0.05)。联合组术后术后症状消失时间(22.25±5.11)h和住院时间(5.63±1.13)d均显著短于单纯套扎组的(29.02±4.63)h、(7.59±1.02)d(P<0.05)。两组治疗48 h后PVD、PVF和PVV均显著小于治疗前,且联合组PVD(12.20±1.63)mm、PVF(585.41±56.23)ml/min和PVV(18.27±3.26)cm/s均显著小于单纯套扎组的(13.65±1.89)mm、(729.65±48.11)ml/min、(21.02±3.19)cm/s(P<0.05)。联合组不良事件发生率(10.91%)与单纯套扎组(7.27%)比较,差异无统计学意义(P>0.05)。联合组术后5d再出血率(1.82%)、术后6周再出血率(1.82%)均显著低于单纯套扎组(16.36%、12.73%)(P<0.05);两组术后1年再出血率比较,差异无统计学意义(P>0.05);联合组术后1年内死亡率(1.82%)显著低于单纯套扎组(12.73%)(P<0.05)。结论内镜下套扎术联合奥曲肽治疗肝硬化合并食管胃底静脉曲张破裂出血患者,可有效改善门静脉血流动力学指标,促进患者彻底止血,加快康复进程,但并未增加不良事件风险,安全性和有效性均较高。Objective To explore the effect of octreotide combined with endoscopic ligation in the treatment of patients with cirrhosis complicated with esophageal and gastric variceal bleeding.Methods A total of 110 patients with cirrhosis complicated with esophageal and gastric variceal bleeding were selected,of which 55 patients receiving endoscopic ligation alone were selected as the single ligation group,and 55 patients receiving octreotide combined with endoscopic ligation were selected as the combination group.Comparison was made on hemostatic effect,disappearance time of postoperative symptoms and length of hospital stay,portal hemodynamic indexes[portal vein diameter(PVD),portal vein flow(PVF),portal vein velocity(PVV)],adverse events and prognosis between the two groups.Results The total effective rate of the combination group(98.18%)was significantly higher than that of single ligation group(83.64%)(P<0.05).The disappearance time of postoperative symptoms and length of hospital stay were(22.25±5.11)h and(5.63±1.13)d in the combination group,which were significantly shorter than(29.02±4.63)h and(7.59±1.02)d in the single ligation group(P<0.05).After 48 h of treatment,PVD,PVF and PVV in both groups were significantly lower than those before treatment;the combination group had PVD of(12.20±1.63)mm,PVF of(585.41±56.23)ml/min and PVV of(18.27±3.26)cm/s,which were significantly lower than(13.65±1.89)mm,(729.65±48.11)ml/min and(21.02±3.19)cm/s in the single ligation group(P<0.05).There was no significant difference in the incidence of adverse events between the combination group(10.91%)and the single ligation group(7.27%)(P>0.05).The rebleeding rate at 5 d postoperatively(1.82%)and at 6 weeks postoperatively(1.82%)in the combination group were significantly lower than those of the simple ligation group(16.36% and 12.73%)(P<0.05).Comparison of 1-year postoperative rebleeding rates between the two groups showed no statistically significant difference(P>0.05).The mortality rate at 1 year postoperatively in the com

关 键 词：奥曲肽 内镜下套扎术 肝硬化 食管胃底静脉曲张破裂出血 

分 类 号：R575.2[医药卫生—消化系统]