摘要
目的探讨食管胃底静脉曲张破裂出血的内镜下治疗效果。方法采用便利抽样法选择2017年6月至2020年2月本院接收的60例食管胃底静脉曲张破裂出血患者,将其随机划分为对照组与观察组,对照组20例接受内科药物治疗(PPI+奥曲肽);观察组40例则接受内镜下精准治疗,包括内镜下套扎、注射硬化剂及组织胶,比较两组止血成功率、静脉曲张改善率及治疗前后静脉曲张直径、VAS评分、不良反应发生率、止血时间、住院时间、住院费用、随访结果等指标。结果观察组止血成功率、静脉曲张改善率均高于对照组,差异有统计学意义(P<0.05),治疗前两组静脉曲张直径和VAS评分比较,差异无统计学意义(P>0.05),治疗后两组静脉曲张直径与VAS评分均有所减少,其中观察组静脉曲张直径明显小于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05);观察组患者平均止血时间短于对照组,差异有统计学意义(P<0.05),两组住院时间、住院费用比较,差异无统计学意义(P>0.05);试验结束后对两组患者进行为期6个月的随访,观察组早期再出血率明显低于对照组,而远期再出血率、静脉曲张消失率及病死率与对照组比较,差异无统计学意义(P>0.05)。结论实施内镜下精准治疗将对食管胃底静脉曲张破裂出血患者提供更为有效的治疗措施,减少此类患者的病死率,延长生命周期,提高生活质量。
Objective To explore the effect of endoscopic treatment for esophagogastric variceal bleeding.Methods A total of sixty patients with esophagogastric variceal bleeding who were admitted to our hospital from June 2017 to February 2020 were selected by the convenience sampling method,and were randomly divided into the control group and the observation group.Twenty patients in the control group were treated with internal medicine therapy(PPI+octreotide).Forty patients in the observation group were treated with accurate endoscopic treatment,including endoscopic loop ligature,and the injection of sclerosing agent and tissue adhesive.The success rate of hemostasis,varicose vein improvement rates,and varicose vein diameters,VAS scores,incidences of adverse reactions,the hemostasis time,hospitalization durations,hospitalization costs and follow-up result were compared between the two groups.Results The success rate of hemostasis and the varicose vein improvement rate in the observation group were higher than those in the control group,and the differences between the two groups were statistically significant(P<0.05).Before treatment,no statistical differences were observed in the varicose vein diameter and VAS score between the two groups(P>0.05).After treatment,varicose vein diameters and VAS scores were decreased in both groups,and the varicose vein diameter and VAS score in the observation group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).No statistical difference was observed in the total incidence of adverse reactions between the two groups(P>0.05).The average hemostasis time in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).No statistical differences were observed in hospitalization durations and hospitalization costs between the two groups(P>0.05).After the end of the experiment,patients in the two groups were followed up for 6 months.The rate of early rebleeding in the observation group was significantly lower than that in the control group,while no statistical differences were observed in the rates of long-term rebleeding,loss of varicose veins and death between the two groups(P>0.05).Conclusion The implementation of accurate endoscopic therapy will provide more effective treatment measures for patients with esophagogastric variceal bleeding,reduce the mortality rate of such patients,prolong the life cycle and improve the quality of life.
作者
胡娜
叶长根
戴华梅
杨力
向阳
查诚宜
冷芳
HU Na;YE Changgen;DAI Huamei;YANG Li;XIANG Yang;ZHA Chengyi;LENG Fang(Department of Gastroenterology,Jingdezhen Third People's Hospital in Jiangxi Province,Jingdezhen 333000,China)
出处
《中国现代医生》
2021年第29期60-63,共4页
China Modern Doctor
基金
江西省景德镇市科技计划项目(20182SFZC058)。
关键词
食管胃底静脉曲张破裂出血
内镜
硬化剂
组织胶
Esophagogastric variceal bleeding
Endoscope
Sclerosing agent
Tissue adhesive
