急诊EVL治疗食管静脉曲张出血临床疗效观察

The Study of Clinical Effectiveness of Endoscopic Variceal Ligation(EVL) at Emergency in the Treatment of Acute Esophageal Variceal Bleeding

目的探讨急诊EVL对食管静脉曲张破裂出血的治疗价值。方法对148例肝硬化食管静脉曲张出血急诊患者随机分为两组,一组接受EVL治疗(EVL组),另一组接受持续药物治疗(奥曲肽组),观察两组的有效性、并发症和近期再出血率。结果两组病人一般特征,支持治疗或一般治疗无明显差别;EVL组较药物治疗组有明显高的控制止血率和低的再出血率,EVL组止血率为96%,而药物治疗组为74%(P<0.05),再出血率EVL组8%,药物治疗组38%(P<0.01)。结论EVL是食管静脉曲张破裂出血的一种有效的止血方法。

Objective To explore the cost of endoscopic variceal ligation（EVL） at emergency in the treatment of acute esophageal variceal bleeding in cirrhoticpatients.Methods One hundred and Seventy-eightpatients with active variceal bleeding,were assigned to two groups receiving either combined therapy of EVL at emergency and octreotide（＇EVL＇ group） or a continuous infusion of octreotide alone（octreotide＇ group）.Both efficacy and cost-effectiveness were observed Results There were no significant differences between the two groups in patients＇ characteristics,supporting treatment or general treatment In group EVL,there appeared a significantly higher rate in controlling bleeding than that of octreotide group（96%vs.74%,P0.05）.Early rebleeding was also lowerin group EVL（8%vs.38%,P0.01） Conclusion The therapeutic scheme of emergency EVL wasamorecost-effective one for controllingacute esophageal variceal bleeding.