套扎术联合奥曲肽治疗食管胃底静脉曲张破裂出血疗效观察及护理.docVIP

套扎术联合奥曲肽治疗食管胃底静脉曲张破裂出血疗效观察及护理 　　[摘要] 目的 观察及探讨急诊套扎术治疗食管胃底静脉曲张出血的效果及护理。方法 选择我科2010年7月～2013年12月100例食管胃底静脉曲张破裂出血患者随机分为治疗组与对照组，每组50例，对照组给予输注奥曲肽进行治疗，治疗组给予内镜下急诊套扎术联合奥曲肽治疗，治疗过程中给予相应的心理、病情、饮食生活护理，并比较两组患者的疗效。结果 与对照组相比，治疗组的止血成功率明显提高，再出血率明显降低（P均0.05）。结论 与单用奥曲肽治疗组相比，奥曲肽联合内镜下套扎术治疗食管胃底静脉曲张破裂出血能有效提高止血成功率及降低再出血率。 　　[关键词] 食管胃底静脉曲张出血；内镜下套扎术；奥曲肽；护理 　　[中图分类号] R575.2 [文献标识码] B [文章编号] 1673-9701（2014）31-0076-03 　　Effect of endoscopic variceal ligation combined with octreotide in treatment of esophageal variceal bleeding and nursing 　　DAI Yanqing LIANG Min DU Xiuzhen 　　Department of Gastroenterology， Houjie Hospital of Dongguan City in Guangdong Province， Dongguan 523900， China 　　[Abstract] Objective To investigate the effect of endoscopic variceal ligation combined with octreotide in treatment of esophageal variceal bleeding and the corresponding clinical nursing pathway. Methods From July 2010 to December 2013， 100 cases of patients with esophageal variceal bleeding were randomly divided into the treatment group and the control group with 50 patients in each group. The treatment group were treated with endoscopic variceal ligation combined with octreotide and the control group were treated with only octreotide. The hemostasis rate and the rebleeding rates were compared between two groups. Results The hemostasis rate of the treatment group was higher than the control group， the rebleeding rates of treatment group was lower than the control group （P all 0.05）. Conclusion Endoscopic variceal ligation combined with octreotide in treatment of esophageal variceal bleeding can improve the hemostasis rate， and reduce the rebleeding rate. 　　[Key words] Esophageal variceal bleeding； Endoscopic variceal ligation； Octreotide； Nursing 　　急性食管胃底静脉曲张破裂出血是肝硬化失代偿期门脉高压患者的严重并发症，因病因和出血部位特殊，临床上由食管胃底静脉曲张破裂出血导致的上消化道出血死亡率高达20%～40%。近年来，随着内镜技术的进展，经内镜下食管静脉曲张套扎术是目前临床上治疗急性食管胃底静脉曲张破裂出血的常用手段[1，2]。本文总结本院近年来收治的食管胃底静脉曲张破裂出血患者，对应用内镜下套扎术联合奥曲肽治疗及单用奥曲肽治疗进行比较，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　全部病例为我院消化内科2010年7月～2013年12