中国医学创新目次食管静脉曲张套扎术联合内镜下硬化剂治疗对肝硬化上消化道出血的效果评价

麦国　王桢桢　柯达

【摘要】 目的：探讨对肝硬化上消化道出血患者行食管静脉曲张套扎术联合内镜下硬化剂治疗的效果。方法：选择2015年1月-2017年1月本院收治的112例肝硬化上消化道出血患者研究观察，按照随机数字表法分为常规组与研究组，每组56例。常规组行食管静脉曲张套扎术联合常规剂量生长抑素治疗，研究组行食管静脉曲张套扎术联合内镜下硬化剂治疗及常规剂量生长抑素治疗。比较两组治疗效果。结果：研究组平均止血时间（26.5±4.7）h较常规组（35.8±5.9）h均明顯降低，差异有统计学意义（t=9.226，P=0.000）。研究组术前止血率较常规组均明显升高，差异有统计学意义（P<0.05）。研究组术后止血率与常规组比较，差异无统计学意义（P>0.05）。研究组不良反应发生率与常规组比较，差异无统计学意义（P>0.05）。研究组早期再出血发生率明显低于常规组，差异有统计学意义（P<0.05）。迟发性再出血发生率与常规组比较，差异无统计学意义（P>0.05）。研究组术后并发症发生率1.8%与常规组7.1%比较，差异无统计学意义（字2=1.884，P=0.170）。结论：对肝硬化上消化道出血患者行食管静脉曲张套扎术联合内镜下硬化剂治疗及常规生长抑素治疗根除率较高、再出血率也较低，并发症减少，且运用安全性较高，值得推广。

【关键词】 肝硬化； 上消化道出血； 食管静脉曲张套扎术； 内镜下硬化剂治疗； 生长抑素

Evaluation of Esophageal Variceal Ligation Combined with Endoscopic Injection Sclerotherapy in treatment of Upper Gastrointestinal Hemorrhage of Liver Cirrhosis/MAI Guo，WANG Zhenzhen，KE Da，et al.//Medical Innovation of China，2018，15（16）：0-050

【Abstract】 Objective：To explore the effect of esophageal variceal ligation combined with endoscopic injection sclerotherapy in the treatment cirrhosis and upper gastrointestinal hemorrhage of liver cirrhosis.Method：A total of 112 cases of upper gastrointestinal bleeding from January 2015 to January 2017 were observed and divided into routine group and research group，56 cases in each group.The routine group were treated with esophageal variceal ligation combined with conventional dose somatostatin.The research group were treated with esophageal variceal ligation combined with endoscopic injection sclerotherapy and conventional dose somatostatin.The therapeutic effects were compared between the two groups.Result：The average hemostasis time in the research group（26.5±4.7）h was significantly lower than that in the routine group （35.8±5.9）h，the difference was statistically significant（t=9.226，P=0.000）.The preoperative hemostasis rate in the research group was significantly higher than that in the routine group，the difference was statistically significant（P<0.05）.There were no statistically significant in the postoperative hemostasis rateand the incidence of adverse reactions in the postoperative hemostasis rate between the two groups（P>0.05）.The incidence of early rebleeding in the research group was lower than that in the routine group，the difference was statistically significant（P<0.05）.There was no statistically significant in the incidence of delayed rebleeding between the two groups（P>0.05）.There was no statistically significant in the incidence of postoperative complications between the study group of 1.8% and the routine group of 7.1%（字2=1.884，P=0.170）.Conclusion：The esophageal variceal ligation combined with endoscopic injection sclerotherapy and conventional dose somatostatin in the treatment cirrhosis and upper gastrointestinal hemorrhage of liver cirrhosis has high eradication rate，lower rebleeding rate，less complications and high safety，which is worth popularizing.

【Key words】 Liver cirrhosis； Upper gastrointestinal hemorrhage； Endoscopic variceal ligation； Endoscopic injection sclerotherapy； Somatostatin

First-authors address：Maoming Peoples Hospital，Maoming 525000，China

doi：10.3969/j.issn.1674-4985.2018.16.014

肝硬化是肝臟慢性进行性疾病，是因肝炎、酒精、血吸虫多种因素弥漫性肝损害疾病。肝硬化患者病程较长，病情常反复发作，患者肝脏结构变化，导致肝脏逐渐变形、变硬变化。门静脉高压是肝硬化患者的主要特征，长期门静脉高压下极易诱发肝性脑病、上消化道出血等相关并发症，增加患者死亡风险。食……