生长抑素联合内镜套扎术治疗食管静脉曲张破裂出血临床研究.docVIP

生长抑素联合内镜套扎术治疗食管静脉曲张破裂出血临床研究 　　[摘要] 目的：探讨生长抑素联合内镜套扎术（EVL）治疗食管静脉曲张破裂出血（EVB）的临床价值。方法：将86例肝硬化门脉高压急性EVB患者分为两组，对照组40例给予EVL治疗，治疗组46例，术前开始联用生长抑素。结果：治疗组与对照组比较，EVL术前止血率分别为60.9%和37.5%，EVL术后止血率均为100%，早期再出血率分别为0和15%，迟发再出血率分别为13.0%和12.5%，死亡率均为0，术前止血率及早期再出血两组比较P0.05，差异有统计学意义，EVL术后止血率、迟发再出血率及死亡率比较P＞0.05，差异无统计学意义。结论：生长抑素联合EVL治疗EVB，能提高EVL术前止血率，减少EVL术后早期再出血率，是最理想的治疗方法。 　　[关键词] 内镜套扎术；生长抑素；食管静脉曲张破裂出血；临床研究 　　[中图分类号] R655.4 [文献标识码]A[文章编号]1674-4721（2011）08（b）-058-02 　　 　　Smatostatin combined endoscopic band ligation for esophageal variceal hemorrhage clinical study 　　TANG Fuying, YANG Xinkui, XIE Hongmin, ZHONG Yongfeng, LIU Jinxiu 　　Department of Gastroenterology, Chen Xinghai Affiliated Hospital of Guangzhou Medical College, Zhongshan City, Zhongshan 528415, China 　　[Abstract] Objective: To investigate somatostatin combined endoscopic band ligation (EVL) treatment of esophageal variceal bleeding (EVB) clinical value. Methods：86 patients with acute EVB portal hypertension were divided into two groups, control group of 40 treated with EVL, the treatment group 46 cases, started before surgery combined with somatostatin. Results: VS control group: EVL preoperative bleeding rate of 60.9% vs 37.5% EVL 100% rate of postoperative bleeding, early rebleeding 0% vs 15%, late rebleeding 13.0% vs 12.5%, mortality are 0, before surgery to stop bleeding and early rebleeding rate of P0.05, no statistically significant. Conclusion: Somatostatin combined EVL treatment EVB, EVL can improve the preoperative bleeding rate, reduce the rate of early rebleeding after EVL, is the best treatment. 　　[Key words]Endoscopic band ligation; Somatostatin; Esophageal varices; Clinical study 　　 　　肝硬化在我国是常见病，食管静脉曲张出血（esophageal varicealbleeding, EVB）是该病严重并发症，食管静脉曲张套扎术（endoscopic variceaI ligation, EVL）治疗EVB效果肯定。本科2001年1月～2011年3月共治疗EVB 86例，现总结分析报道如下： 　　1 资料与方法 　　1.1一般资料 　　 本组患者86例，临床已确诊肝硬化及门静脉脉高压，紧急内镜确诊为EVB。其中，男62例，女24例，年龄为46～78岁，平均（61.8±1.2）岁，肝炎后肝硬化77例，酒精性肝硬化6例，曾行脾切除加断流术3例。肝功能Child-pugh分级A级16例，B级28例，C级42例。食管