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目的观察生长抑素与生长抑素联合内镜下聚桂醇+组织黏合剂治疗肝硬化并食管胃底静脉曲张出血(esophageal gastric varices bleeding,EGVB)患者的临床疗效。方法分析首都医科大学附属北京地坛医院2014年1月至2014年12月收治的167例肝硬化并EGVB患者,对照组(21例)仅给予生长抑素治疗,治疗组(146例)给予生长抑素联合内镜下治疗,两组均应用保肝、利尿及普萘洛尔治疗,观察急诊止血成功率以及随访1周、1个月、3个月后两组患者曲张静脉的消失率和病死率。结果对照组和治疗组的急诊止血成功率分别为90.5%(19/21)和99.3%(145/146),差异有统计学意义(χ~2=4.065,P=0.042)。随访1周、1个月、3个月,两组再出血率分别为9.5%(2/21)、23.8%(5/21)、42.9%(9/21)和0.7%(1/146)、2.1%(3/146)和3.4%(5/146),差异有统计学意义(χ~2值分别为4.065、14.579和32.212,P值分别为0.042、0.000和0.000)。随访至3个月,两组曲张静脉消失率为分别为0%(0/21)和21.2%(31/146),差异有统计学意义(χ~2=4.161,P=0.041);两组病死率分别为为9.5%(2/21)、0%(1/146),差异有统计学意义(χ~2=5.894,P=0.015)。结论生长抑素联合内镜治疗肝硬化并EGVB患者,曲张静脉消失率显著增加,病死率显著下降,是一种止血快、效果好且安全有效的方法。
Objective To observe the clinical effect of somatostatin and somatostatin combined with lauromacyl alcohol + tissue adhesive in the treatment of patients with liver cirrhosis and esophageal gastric varices bleeding (EGVB). Methods 167 patients with cirrhosis and EGVB were enrolled from Beijing Ditan Hospital, Capital Medical University from January 2014 to December 2014. The control group (21 cases) was treated with somatostatin only. The treatment group (146 cases) Superoxide dismutase combined with endoscopic treatment. Both groups were treated with hepatoprotective, diuretic and propranolol treatment. The success rate of emergency hemostasis and the rate of disappearance of varicose veins and death of the two groups were observed after 1 week, 1 month and 3 months follow-up rate. Results The success rates of emergency hemostasis in control group and treatment group were 90.5% (19/21) and 99.3% (145/146), respectively. The difference was statistically significant (χ ~ 2 = 4.065, P = 0.042). Followed up for 1 week, 1 month and 3 months, the rates of rebleeding were 9.5% (2/21), 23.8% (5/21), 42.9% (9/21) and 0.7% (1/146) , 2.1% (3/146) and 3.4% (5/146) respectively. The difference was statistically significant (χ ~ 2 values were 4.065, 14.579 and 32.212, P values were 0.042, 0.000 and 0.000, respectively). Followed up to 3 months, the disappearance rates of varicose veins in two groups were 0% (0/21) and 21.2% (31/146) respectively, with significant difference (χ ~ 2 = 4.161, P = 0.041) The case fatality rates were 9.5% (2/21) and 0% (1/146), respectively. The difference was statistically significant (χ ~ 2 = 5.894, P = 0.015). Conclusion Somatostatin combined with endoscopic treatment of cirrhosis and EGVB patients, varicose vein disappearance rate increased significantly, the mortality decreased significantly, is a fast bleeding, effective and safe and effective method.