血凝酶治疗肝硬化食管胃底静脉曲张破裂出血49例疗效研究.docVIP

血凝酶治疗肝硬化食管胃底静脉曲张破裂出血49例疗效研究[摘要] 目的：观察血凝酶对肝硬化食管胃底静脉曲张破裂出血的疗效。方法：肝硬化食管胃底静脉曲张破裂出血患者122例，分治疗组49例和对照组73例，治疗组在对照组治疗的基础上加用血凝酶，比较两组的有效率如止血时间、输血量的变化。结果：治疗组有效率明显高于对照组（P＜0.05）；止血时间和输血量明显短于和少于对照组（P＜0.01）。结论：血凝酶能有效地缩短肝硬化患者食管胃底静脉曲张破裂出血的时间，减少输血量。 [关键词] 血凝酶；肝硬化；食管胃底静脉曲张；出血 [中图分类号] R571[文献标识码]B [文章编号]1673-7210（2007）12（c）-091-02 Effects of hemocoagulase on bleeding caused by rupture of gastro-esophageal varices induced hepatic cirrhosis －analysis of 49 cases WU Yi-huai,LIU Wei (Department of Gastroenterology, Chenzhou No.1 Peoples Hospital， Chenzhou423000,China) [Abstract] Objective：To investigate the effects of hemocoagulase on bleeding caused by rupture of gastro-esophageal varices. Methods: 122 patients were divided into hemocoagulase-treated group(TG, 49 cases) and control group(CG, 73 cases), TG were used with hemocoagulase, and the other treatments were as same as those in CG. Effective rate, time of bleeding and volume of blood transfusion were analyzed. Results: The efective rate in TG was significantly higher than that in CG（P＜0.05）, time of bleeding was notably shorter and volume of blood transfusion was fewer in TG than those in CG（P＜0.05）.Conclusion: Hemocoagulase could shorten the time of bleeding and reduce volume of blood transfusion of patients with hepatic cirrhosis complicated with rupture of gastro-esophageal varices. [Key words] Hemocoagulase; Hepatic Cirrhosis; Gastric-esophageal arices;Bleeding 食管胃底静脉曲张破裂出血是肝硬化的严重并发症之一，出血量大，死亡率高，常需积极止血。本文观察了血凝酶、生长抑素和泮托拉唑联用治疗食管胃底静脉曲张破裂出血，效果较好，现总结如下： 1 资料与方法 1.1一般资料 2005年3月～2007年6月，因呕血、便血等症状就诊，胃镜证实均为中重度食管胃底静脉曲张破裂出血，未行内镜下治疗的住院患者122例，分治疗组49例，其中男33例，女16例，平均年龄（44.7±12.1）岁；乙型肝炎后肝硬化28例，丙型肝炎后肝硬化3例，酒精性肝硬化14例，其他原因的肝硬化4例；肝功能A级6例，B级18例，C级25例；食管出血44例，胃底出血3例，两者均出血2例。对照组73例，其中男52例，女21例，平均年龄（46.2±13.4）岁；乙型肝炎后肝硬化43例，丙型肝炎后肝硬化6例，酒精性肝硬化18例，其他原因的肝硬化6例；肝功能A级6例，B级31例，C级36例；食管出血64例，胃底出血5例，两者均出血4例。两组患者的年龄、性别、病程及病情严重程度构成比差异无显著性(P＞0.05)。 1.2 方法 1.2.1 对照组 常规禁食，补充血容量及对症治疗；生长抑素(海南中和制药有限公司)0.25 mg加入生理盐水30 ml静脉缓慢推注后,生长抑素3