联合应用奥曲肽和内镜套扎治疗肝硬化食管静脉曲张破裂出血

Combination of Octreotide and Endoscopic Ligation in Treatment of Hemorrhage Caused by Ruptured Esophageal Varices

目的:观察奥曲肽,内镜套扎和联合上述两种方法治疗食管静脉曲张破裂出血的疗效。方法:56例患者分为三组,奥曲肽组19例,内镜套扎组20例,联合治疗组17例。结果:72小时止血率在三组分别为68.4%,80%和94.1%;1周内再出血率为30.8%,12.5%和6.3%;急诊手术率为26.3%,21.1%和5.9%。联合治疗组的72小时止血率明显高于其他两组(P<0.05),1周再出血率和急诊手术率低于其他两组(P<0.05)。奥曲肽组和内镜套扎组的72小时止血率则没有差别(P>0.05)。结论:食管静脉曲张破裂出血时联合应用奥曲太和内镜套扎治疗可以提高止血率,降低近期再出血率和急诊外科手术率。

Objective：To evaluate the efficacy of octreotide or endoscopic ligation and combination of both in controlling the hemorrhage of esophageal varices.Methods：The 56 patients divided into three groups, 19 received octreotide infusion,20 received endoscopic ligation,and 17 received combination of both.Results：In three groups hemostasis rates（within 72 hours） were 68.4%,80% and 94.1% respectively, rebleeding rates（within a week） were 30.8%,12.5% and 6.3% and emergency operation rates were 26.3%,21.2% and 5~9% respectively.The hemostatic effect of the combination group was better than that of other groups（P〈0.05）,rebleeding rates and emergency operation rates were less than other groups （P〈0.05）.No significant difference between endoscopic ligation group and octreotide group in hemostatic efficacy（P〉0.05）. Conclusion：Conbination of oetreotide and endoscopic ligation increased the rates of stopping bleeding,and dcreased the rates of rebteeding and emergency operation in management of variceal hemorrhage.