| 摘要: |
| ［摘要］ 目的 探讨内镜套扎术联合药物预防食管静脉曲张破裂出血的有效性。方法 将64例肝硬化伴食管静脉曲张破裂出血患者随机分为治疗组33例（内镜套扎术+普萘洛尔+单硝酸异山梨醇酯）和对照组31例（普萘洛尔+单硝酸异山梨醇酯）分别进行治疗，对比两组治疗前后内镜下食管静脉曲张变化、血液动力学监测结果和再出血率等情况。结果 治疗后两组Dpv、Dsv、Qpv、Qsv与治疗前比较均显著下降（P<0.05），Vpv、Vsv治疗前后比较，差异无统计学意义，两组血液动力学监测对比, 差异无统计学意义（P>0.05）；6个月时治疗组有3例（9%）、对照组有6例（19.4%）再次发生出血，两组再出血率差异有统计学极显著意义（P<0.01），12个月时治疗组共有4例（12.1%）对照组共有11例(35.5%)再次发生上消化道出血，两组再出血率差异仍有统计学极显著意义（P<0.01）；64例进行胃镜复查，治疗组6个月时食管静脉曲张轻度或消失为51.5%（17/33），12个月时为48.5%（16/33），对照组6个月和12个月均为3.2%（1/31），由中度变为轻度。结论 内镜套扎术联合药物预防食管静脉曲张破裂出血效果优于单纯药物治疗，且安全、效果明显，病人易接受，可作为预防食管静脉曲张破裂出血的首选方法。 |
| 关键词: 内镜套扎术 药物 食管静脉曲张 预防 |
| DOI：10.3969/j.issn.1674-3806.2009.09.30 |
| 分类号:R 571 |
| 基金项目: |
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| Effect observation on EVL combining with drug in the prophylaxis of esophageal varicosity bleeding |
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LU Rui-ming
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Wuzhou People′s Hospital, Guangxi 543000, China
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| Abstract: |
| ［Abstract］ Objective To explore the effectiveness of endoscopic varicosity ligation (EVL) combining with drug in the prophylaxis of esophageal varicosity bleeding.Methods Sity-Four liver cirrhosis patients with esophageal varicosity bleeding were divided into the treatment and the control groups. In the treatment group 33 cases were treated with EVL combining with propranolol and isosorbide mononitrate, whereas 31 cases in the control group were merely treated with propranolol and isosorbide mononitrate. The rate of rebleeding, the condition of blood dynamics and esophageal varicosity were observed in the both groups.Results Compared with before treatment, there were remarkable difference in the Indexes of Dpv, Dsv, Qpv and Qsv （P<0.05）; while, not difference in the Indexes of Vpv and Vsv (P>0.05). There was no statistical difference in the condition of blood dynamics between the both groups (P>0.05). 9%(3/33) cases, 19.4%(6/31) cases were respectively found rebleeding in 6 months after treatment in the treatment and the control groups （P<0.01）.In the mean time 12.1%(4/33)cases, 35.5%(11/31) cases were respectively found having rebleeding in 12 months after treatment in the treatment and the control groups, too （P<0.01）. The esophageal varicosity of 51.5% (17/33) cases in 6 months, 48.5%(16/33) in 12 months was found to alleviate or disappear after treatment in the treatment group; While in the control group 3.2%(1/31) cases equally were found to develop into middle and lower varicosity in 6 and 12 months under endoscope.Conclusion The effectiveness of EVL combining with drug in the prophylaxis of esophageal varicosity bleeding is superior to only drugs, it is safe, ease and can be used as the first method in the prophylaxia of esophageal varicosity bleeding. |
| Key words: Endoscopic varicosity ligation (EVL) Drug Esophageal varicosity bleeding Prophylaxis |
