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卡维地洛联合EVL预防肝硬化腹水患者食管静脉曲张再出血的临床研究 被引量:1

Clinical Study of Carvedilol Combined with EVL in Preventing Esophageal Variceal Rebleeding in Patients with Cirrhosis and Ascites
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摘要 目的:探讨卡维地洛联合内镜套扎术(EVL)预防肝硬化腹水患者食管静脉曲张再出血的临床研究。方法:选取本院2016年1月-2018年2月收治肝硬化腹水食管静脉曲张破裂出血患者76例,依据入院诊治时间的先后顺序将患者分成对照组和观察组,每组38例。对照组行普萘洛尔联合EVL治疗,观察组行卡维地洛联合EVL治疗。患者术后均随访12个月,比较两组临床疗效、再出血发生率、脾脏硬度及不良反应发生情况。结果:术后随访12个月,观察组临床总有效率为92.11%,高于对照组的73.68%,差异有统计学意义(χ^2=4.574,P=0.033);观察组食管静脉曲张再出血率为10.53%,明显低于对照组的31.58%,差异有统计学意义(P<0.05);治疗12个月后,两组脾脏硬度弹性值均较治疗前明显降低,且观察组低于对照组,差异均有统计学意义(P<0.05);观察组不良反应总发生率为18.42%,低于对照组的42.11%(P<0.05)。结论:卡维地洛联合EVL可增强肝硬化腹水患者食管静脉曲张再出血的临床疗效,减少再出血发生率,降低脾脏硬度,具有良好的安全性,值得应用推广。 Objective:To investigate the clinical study of Carvedilol combined with endoscopic ligation(EVL)for the prevention of esophageal varicose rebleeding in patients with cirrhotic ascites.Method:A total of 76 patients with rupture and hemorrhage of esophageal varicose veins in cirrhosis and ascites admitted to our hospital from January 2016 to February 2018 were selected.According to the time sequence of admission,the patients were divided into control group and observation group,38 cases in each group.Patients in the control group received Propranolol combined with EVL,and patients in the observation group received Carvedilol combined with EVL.The patients were followed up for 12 months,and the clinical effect,rebleeding rate,spleen hardness and adverse reactions were compared between the two groups.Result:After 12 months follow-up,the total clinical effective rate of the observation group was 92.11%,higher than 73.68% of the control group,the difference was statistically significant(χ^2=4.574,P=0.033).The rebleeding rate of esophageal varices in the observation group was 10.53%,which was significantly lower than 31.58% in the control group,the difference was statistically significant(P<0.05).After 12 months of treatment,the hardness and elasticity of spleen in the two groups were significantly lower than those of before treatment,and the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 18.42%,lower than 42.11% in the control group(P<0.05).Conclusion:Carvedilol combined with EVL can enhance the clinical efficacy of esophageal varicose rebleeding in patients with cirrhotic ascites,reduce the incidence of rebleeding,reduce the hardness of spleen,and have good safety,worthy of application and promotion.
作者 叶鹏 魏应凤 万云 顾秋平 谢俊锋 YE Peng;WEI Yingfeng;WAN Yun;GU Qiuping;XIE Junfeng(Ganzhou People’s Hospital,Ganzhou 341000,China)
出处 《中国医学创新》 CAS 2019年第36期74-78,共5页 Medical Innovation of China
基金 赣州市指导性科技计划项目(GZ2018ZSF231)
关键词 卡维地洛 内镜套扎 肝硬化 食管静脉曲张 Carvedilol Endoscopic ligation Cirrhosis Esophageal varices
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