| 石兵 蒋雨卉 吕琳 赵红云 张玉婷.内镜与药物治疗肝硬化伴食管静脉曲张破裂出血的疗效比较[J].,2016,16(12):2309-2311 |
| 内镜与药物治疗肝硬化伴食管静脉曲张破裂出血的疗效比较 |
| Cirrhosis and Esophageal Variceal Bleeding：Efficacy Comparison of Endoscopy and Medication |
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| DOI： |
| 中文关键词: 套扎术 肝硬化 食管静脉曲张 出血 |
| 英文关键词: Ligation Cirrhosis Esophageal varices Bleeding |
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| 中文摘要: |
| 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3
mg+50 mL生理盐水泵入，兰索拉唑40 mg+100 mL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。 |
| 英文摘要: |
| Objective:To explore the clinical efficacy of endoscopy and medication in treatment of patients with cirrhosis and
esophageal variceal bleeding (EVB).Methods:A total of 70 patients with cirrhosis and EVB, who were treated in the Affiliated
University-Town Hospital of Chongqing Medical University fromJanuary 2012 to August 2013, were selected and randomly divided into
control group (n=35) and observation group (n=35). The two groups were treated with correcting anemia and expanding blood volume
after admission. After the condition was stable, the observation group was treated with esophageal variceal ligation (EVL) under
endoscopy in the case of pharyngeal anesthesia, while the control group was treated with somatostatin 3 mg+50 mL saline pumping and
lansoprazole 40 mg+100 mL saline intravenous infusion. The clinical total effective rates, recurrence rates and the incidence of adverse
reactions in the two groups were compared.Results:The total effective rate (91.43%) of observation group was significantly higher than
that(71.43%) of control group(P<0.05); the bleeding recurrence rate(5.71%) in observation group was lower than that(22.86%) of control
group (P<0.05); the incidence of esophageal ulcers, fever and retrosternal pain in the observation group were lower than those in the
control group, but the differences had no significance (P>0.05).Conclusion:EVL is effective in the treatment of patients with cirrhosis
and EVB, it can reduce the recurrence rate and the incidence of adverse reaction,and its effect is better than medication treatment,which
is worthy of clinical promotion. |
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