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目的:比较内镜与药物治疗肝硬化伴食管静脉曲张破裂出血(EVB)的疗效。方法:选择2012年1月-2013年8月我院收治的肝硬化伴EVB患者70例,依据随机数字表法将所有患者分为对照组和观察组,各35例。两组患者入院后均给予纠正贫血、扩充血容量治疗,观察组待患者病情稳定后,在咽部麻醉下行内镜下食管静脉曲张套扎疗法(EVL),对照组患者应用生长抑素3mg+50 m L生理盐水泵入,兰索拉唑40 mg+100 m L生理盐水静脉滴注治疗。比较两种治疗方法的临床总有效率、复发率以及不良反应发生率。结果:观察组治疗总有效率91.43%,显著高于对照组71.43%(P<0.05);观察组的出血复发率仅为5.71%,低于对照组的22.86%(P<0.05);观察组食管溃疡、发热和胸骨后疼痛发生率均低于对照组,但差异未见统计学意义(均P>0.05)。结论:EVL治疗肝硬化伴EVB疗效显著,减少复发率和不良发应发生率,效果优于单纯药物治疗,值得在临床上推广。
Objective: To compare the efficacy of endoscopic and drug treatment of cirrhosis with esophageal variceal bleeding (EVB). Methods: Seventy patients with cirrhosis and EVB admitted to our hospital from January 2012 to August 2013 were selected. All patients were divided into control group and observation group according to random number table. After admission, both groups were given anemia correction and extended volume of blood volume treatment. Patients in the observation group were treated with endoscopic esophageal varicose vein ligation (EVL) after pharyngeal anesthesia. The patients in the control group were treated with somatostatin 3 mg + 50 m L saline pump, lansoprazole 40 mg + 100 m L saline for intravenous infusion. The total effective rate, recurrence rate and adverse reaction rate of the two treatment methods were compared. Results: The total effective rate of observation group was 91.43%, significantly higher than that of control group (71.43%, P <0.05). The recurrence rate of observation group was only 5.71%, which was lower than that of control group (22.86%, P <0.05) Esophageal ulcer, fever and post-sternal pain were lower than the control group, but the difference was not statistically significant (P> 0.05). Conclusion: The efficacy of EVL in treating cirrhosis with EVB is significant, reducing the recurrence rate and incidence of adverse reactions, which is superior to simple drug therapy and is worth popularizing clinically.