摘要
目的 探讨早期内镜套扎术(endoscopic ligation of esophageal varices, EVL)对肝硬化并发食管胃静脉曲张破裂出血(esophageal and gastric varices bleeding, EVB)患者临床疗效和术后并发症发生的影响。方法 选取2020年6月-2022年5月在重庆大学附属涪陵医院进行EVL治疗的113例EVB患者的临床资料,将其分为早期手术组(58例),入院后6 h内行食管静脉曲张内镜套扎术;延迟手术组(55例),入院后6~72 h内行EVL,随访1周,观察止血成功率、术后再出血率、术后并发症、住院时间等。结果 早期手术组止血成功率、再次出血率及病死率分别为96.6%、3.4%和5.2%,延迟手术组止血成功率、再次出血率及病死率分别为92.7%、7.3%和9.1%,两组疗效比较,差异无统计学意义(P>0.05)。早期手术组术后肝性脑病发生率6.9%,显著低于延迟手术组的14.5%,差异有统计学意义(χ^(2)=1.740,P<0.05),两组术后肝肾综合征和腹腔积液发生率比较,差异无统计学意义(P>0.05)。早期手术组治疗后止血时间、输血量、住院时间分别为(2.73±1.34)h,(527.27±69.36)U/L,(8.31±2.91)d,均显著优于延迟手术组,差异有统计学意义(t=13.177、8.795、3.960,P<0.05)。结论尽管全身性基础疾病发病率高、肝功能差,早期EVL治疗肝硬化EVB显著减少了术后肝性脑病发生率、缩短了止血时间和住院天数、减少了输血量及住院费用。
Objective To explore the effect of early endoscopic ligation of esophageal varices(EVL)on clinical effi⁃cacy and postoperative complications in patients with cirrhosis complicated by esophageal and gastric varices bleeding(EVB).Methods The clinical data of 113 EVB patients who underwent EVL from June 2020 to May 2022 at Fuling Hospital Affiliated to Chongqing University were selected.They were divided into the early surgery group(58 cases),who underwent endoscopic ligation of esophageal varices within 6 h after admission,and the delayed surgery group(55 cases),who underwent EVL within 6-72 h after admission,and were followed up for 1 week,to observe the success rate of hemostasis,the rate of postoperative rebleeding,postoperative complications,and hospitalization time.Results The success rate of hemostasis,rebleeding rate and death rate were 96.6%,3.4%and 5.2%in the early surgery group,and 92.7%,7.3%and 9.1%in the delayed surgery group,respectively,and there was no statistically significant differ⁃ence in the efficacy of the two groups(P>0.05).The incidence of postoperative hepatic encephalopathy in the early surgery group was 6.9%,which was significantly lower than that of 14.5%in the delayed surgery group,and the differ⁃ence was statistically significant(χ^(2)=1.740,P<0.05),and there was no statistically significant significant difference in the incidence of postoperative hepatic and renal syndromes and peritoneal effusion between the two groups(P>0.05).The hemostasis time,blood transfusion volume and hospitalization time after treatment in the early surgery group were(2.73±1.34)h,(527.27±69.36)U/L,and(8.31±2.91)d,respectively,which were significantly better than those in the delayed surgery group,and the difference was statistically significant(t=13.177,8.795,3.960,P<0.05).Conclusion Despite the high incidence of systemic underlying diseases and poor liver function,early EVL for cirrhosis EVB sig⁃nificantly reduced the incidence of postoperative hepatic encephalopathy,shortened hemostasis time and hospitaliza⁃tion days,and reduced blood transfusion and hospitalization costs.
作者
夏冬丽
唐静
杨雪澜
刘爱民
XIA Dongli;TANG Jing;YANG Xuelan;LIU Aimin(Department of Gastroenterology,Fuling Hospital Affiliated to Chongqing University,Chongqing,408000 China)
出处
《系统医学》
2023年第11期126-129,共4页
Systems Medicine
基金
涪陵区科技计划项目(FLKJ,2021BBB2047)。
关键词
肝硬化
食管胃静脉曲张破裂出血
早期内镜套扎术
术后并发症
住院时间
Cirrhosis
Esophageal and gastric varices bleeding
Early endoscopic ligation
Postoperative complications
Hospitalization time
