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探讨内镜下注射硬化剂联合皮下注射奥曲肽及口服心得安、硝酸甘油等药物治疗食道静脉曲张出血的近远期疗效。方法 :Ⅰ组 (2 2例 )在注射硬化剂前 10～ 30min皮下注射奥曲肽 0 .1mg ,后每 8h 1次 ,连用 3d改为心得安 10～ 40mg/d ,硝酸甘油 1.5～ 2 .0mg/d长期口服 ;Ⅱ组 (2 0例 )单独应用硬化剂治疗。观察 2组早期再出血率 (3d内 )及远期再出血率 (1年内 ) ,并经统计学处理。结果 :Ⅰ组早期再出血率 4.5 % ,明显低于Ⅱ组15 .0 % ;1年随访Ⅰ组再出血 2例 (9.0 % ) ,Ⅱ组 7例 (35 .0 % )。两组比较有显著差异。结论 :内镜下注射硬化剂联合药物治疗食道静脉曲张出血 ,不仅明显降低早期再出血率 ,还可显著降低 1年内远期再出血率。
To explore the short-term efficacy of endoscopic injection of sclerotherapy combined with subcutaneous injection of octreotide and oral propranolol, nitroglycerin and other drugs in the treatment of esophageal varices bleeding. Methods: Group Ⅰ (n = 22) received octreotide 0.1 mg subcutaneously 10 ~ 30 minutes before injection of sclerosing agent, once every 8 hours, and then changed to propranolol 10 ~ 40 mg / d with 3d, nitroglycerin 1.5 ~ 2.0 mg / d long-term oral; Group Ⅱ (20 cases) were treated with sclerotherapy alone. The rate of early rebleeding (3d) and the rate of long-term rebleeding (1 year) in the two groups were observed and statistically analyzed. Results: The rate of early rebleeding in group Ⅰ was 4.5%, which was significantly lower than that in group Ⅱ 15.0%. In group Ⅰ, 2 cases were rebleeding in 2 cases (9.0%) and in group Ⅱ 7 cases (35.0%). There were significant differences between the two groups. Conclusion: Endoscopic injection of sclerotherapy combined with drugs in the treatment of esophageal varices bleeding not only significantly reduce the rate of early rebleeding, but also significantly reduce the rate of long-term one-year rebleeding.