摘要
目的评价应用内镜套扎术(endoscopic variceal ligation,EVL)治疗肝硬化食管静脉曲张破裂出血的临床疗效和效费比。方法选择就诊的肝硬化食管静脉曲张急性破裂出血患者62例,随机分为试验组和对照组,每组31例。对照组采用常规治疗(复苏和药物治疗),试验组在对照组的基础上进行EVL治疗,比较患者的临床疗效,生长抑素类似物(Somatostatin Analogs)与质子泵抑制剂(proton pump inhibitor,PPI)应用天数、输血量,止血天数,治疗前后肝功能(ALT、AST、PT、血氨和Alb)差异,住院天数,住院费用,1年内再出血率以及全因死亡率等。结果试验组的根治率为80.65%显著高于对照组的48.39%(P<0.05);试验组的生长抑素类似物与质子泵抑制剂应用天数,输血量,止血天数,住院天数,住院费用均显著低于对照组,试验组治疗后肝功能改善情况显著优于对照组(P<0.05)。对照组的1年内再出血率以及全因死亡率分别为16.13%和6.45%显著高于试验组的48.39%和25.81%,差异有统计学意义(P<0.05)。结论治疗肝硬化食管静脉曲张破裂出血中应用内镜套扎术具有较好的止血效果,可以显著降低复发率和复发次数,明显减少患者住院时间和住院费用,值得推广。
Objective To investigate the therapeutic effects of endoscopic variceal ligation(EVL)on esophageal variceal bleeding due to liver cirrhosis.Methods Sixty-two patients with esophageal variceal bleeding due to liver cirrhosis who were admitted and treated in our hospital from January 2015 to January 2016 were randomly divided into control group(n=31)and experimental group(n=31).The patients in control group were treated by conventional model(resuscitation and medication therapy),however,the patients in experimental group,on the basis of control group,were treated by endoscopic variceal ligation(EVL).The clinical curative effects,the dosage of somatostatin analogs and proton pump inhibitor(PPI),blood transfusion volume,liver function indexes including ALT,AST,PT,blood ammonia and Alb before and after treatment,hemostatic time,hospitalization days,medical expenses,incidence rate of rebleeding in one-year and all-cause death rate were observed and compared between two groups.Results The radical cure rate in experimental group was 80.65%,which was significantly higher than that(48.39%)in control group(P<0.05).The use dosage of somatostatin analogs and proton pump inhibitor,blood transfusion volume,hemostatic days,length of staying in hospital and cost of hospitalization in experimental group were significantly lower than those in control group(P<0.05).Moreover the liver function indexes in experimental group were sueprior to those in control group(P<0.05).In addition the incidence rate of rebleeding in one-year and all-cause death rate in control group were 48.39%,25.81%,respectively,which were significantly higher than those(16.13%,6.45%,respectively)in experimental group(P<0.05).Conclusion The endoscopic variceal ligation in treatment of esophageal variceal bleeding due to liver cirrhosis has better hemostatic effects,which can significantly reduce relapse rate,length of staying in hospital and cost of hospitalization,thus,which is worth using widely in clinical practice.
作者
刘正金
王学红
谢会忠
韦玲
LIU Zhengjin;WANG Xuehong;XIE Huizhong;WEI Ling(Department of Digestive System Diseases,The Second Xiangya Hospital of Central South University,Hunan,Changsha 570301,China)
出处
《河北医药》
CAS
2018年第8期1228-1230,共3页
Hebei Medical Journal
基金
海南省卫生厅科学研究课题(编号:琼卫2015 PT-38)
关键词
肝硬化
食管静脉曲张
出血
内镜套扎术
liver cirrhosis
esophageal varices
bleeding
endoscopic variceal ligation
