肝硬化患者上消化道出血急诊治疗方法浅析

Preliminary analysis on emergency treatment of upper gastrointestinal bleeding in the patients with hepatic cirrhosis

目的探讨肝硬化患者上消化道出血的原因和急诊治疗方法。方法将60例肝硬化上消化道出血患者随机分为A、B 2组,A组32例,采用单纯内科保守治疗;B组在A组治疗基础上加用三腔二囊管压迫止血,观察2组疗效。结果 A组治疗有效率明显低于B组,差异有统计学意义(P<0.05)。对于Child-Pugh分级为B、C级患者及早应用三腔二囊管压迫止血,能提高抢救成功率,减少并发症并降低病死率。结论在肝硬化上消化道出血治疗过程中,在医院(尤其是基层医院)缺少内镜治疗及外科治疗的条件下,采用三腔二囊管止血仍为一种有效的急救方法,能为抢救患者生命赢得时间和机会。

Objective To explore the reasons and emergency treatment of upper gastrointestinal bleeding in the patients with hepatic cirrhosis.Methods 60 patients with cirrhosis upper gastrointestinal bleeding were divided into two groups A and B.32 cases in group A,using a simple and conservative treatment,B group was treated with three cavity two capsule tube compression hemostasis besides drug treatment,curative effect in 2 groups was observed.Results In group A,the effective rate of treatment was significantly lower than that in group B,there was statistically significant（P0.05）.The patients with Child-Pugh rate B,C level should be given early application of three cavity two capsule tube compression hemostasis,which could improve the success rate of rescue,reduce complications and lower mortality rate.Conclusion During the treatment of cirrhosis with upper gastrointestinal bleeding,the hospital（especially the primary level hospitals） lack of endoscopic therapy and surgical treatment,the three cavity two of cystic duct was an effective method of first aid,for saving the patients lives to win time and opportunity.