内镜下注射组织粘合剂联合普萘洛尔预防胃底静脉曲张临床研究.docVIP

内镜下注射组织粘合剂联合普萘洛尔预防胃底静脉曲张临床研究 　　[摘要] 目的 探讨内镜下注射组织粘合剂联合普萘洛尔预防肝硬化胃底静脉曲张再出血的效果。 方法 将87例肝硬化胃底静脉曲张患者分为两组，联合组45例行注射组织粘合剂同时给予普萘洛尔口服，对照组42例仅行注射组织粘合剂；观察患者出血率、门静脉血流速度（VPV）和门静脉内径（DPV）。 结果 随访9个月，联合组的出血率明显低于对照组（P ＜ 0.05）；联合组VPV变快，DPV变小，与对照组相比差异有统计学意义（P ＜ 0.05）。 结论 内镜下注射组织粘合剂联合普萘洛尔长期口服预防胃底静脉曲张出血效果好。 　　[关键词] 组织粘合剂；胃底静脉曲张出血；普萘洛尔 　　[中图分类号] R571.3 [文献标识码] A [文章编号] 1673-7210（2012）04（a）-0093-02 　　 　　The clinical study of endoscopic injection of tissue adhesive combined with Propranolol in the prevention of gastric varices 　　ZHONG Bibo KOU Jiguang YIN Xiaowu 　　Department of Gastroenterology, Xiaogan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, Xiaogan 432000, China 　　[Abstract] Objective To study the therapeutic effects of endoscopic injection of tissue adhesive combined with Propranolol in the prevention of gastric varices bleeding. Methods 87 cases of cirrhosis with gastric varices were divided into two groups, 45 cases of combination group were given endoscopic injection of tissue adhesive combined with Propranolol, while 42 cases of control group were only given injection of tissue adhesive. The bleeding rate, portal vein blood flow velocity (VPV) and portal vein diameter (DPV) of patients were observed. Results After follow-up for 9 months, the bleeding rate of combination group was significantly lower than control group (P ＜ 0.05), and VPV was faster, DPV was smaller than control group, with statistically significant differences (P ＜ 0.05). Conclusion The treatment effect of endoscopic injection of tissue adhesive combined with long-term oral administration of Propranolol in the prevention of gastric varices bleeding is good. 　　[Key words] Tissue adhensive; Gastric varices bleeding; Propranolol 　　 　　肝硬化导致的食管静脉曲张破裂出血是临床常见急、危重症，其来势凶猛，出血量大，再出血率高，并发症???，死亡率高，严重威胁着肝硬化患者的生命。如何能有效及时地预防肝硬化所致的食管静脉曲张破裂出血，成为临床的关键点之一。目前随着对门脉高压机制的不断深入，各种治疗手段及药物不断的涌现，但并发症多，远期疗效低[1-2]。现为探讨提高治疗肝硬化食管静脉曲张远期疗效，我院采用了药物和内镜治疗为主的非外科手术治疗。