食管胃底静脉出血早期给予肠内营养对预防早期再出血的价值

Esophageal and gastric variceal bleeding in the prevention of early rebleeding given enteral nutrition value after endoscopic variceal ligation and treatment

目的 观察肝硬化食管胃底静脉出血（GEVB）内镜治疗后早期口服营养液对患者降低早期再出血的风险.方法 将78例GEVB内镜治疗后营养不良患者随机分为治疗组（营养液口服组40例）和对照组（常规饮食组38例）,于内镜治疗后12h给予进食,14 d后比较两组再出血发生率及肝功能恢复情况.计量资料用t检验或秩和检验,计数资料用x^2检验或Fisher确切概率法. 结果 治疗组40例患者在术后14d内无再出血发生,对照组38例中5例发生再出血,x^2=5.624,P=0.018.治疗组肝功能各项指标均有明显改善,与对照组差异均具有统计学意义（P值均＜0.05）. 结论 GEVB内镜治疗后患者早期口服营养液可降低患者早期再出血风险并改善患者肝功能及营养不良状况.

Objective To observe liver cirrhosis with esophageal and gastric variceal bleeding （GEVB） after endoscopic variceal ligation and treatment of early oral nutrition liquid in patients administered to reduce the risk of early rebleeding.Methods Seventy-eight patients with cirrhosis who received therapeutic endoscopy after GEVB and who suffered from malnutrition were randomly divided into a treatment group （oral solution group,n =40） and a control group （regular diet group,n =38）.Both of the two groups received food at 12 hours after therapeutic endoscopy.After 14 days,the rates of early rebleeding rate and liver function recovery were compared for the two groups.T-test,rank test,chi-square test and Fisher＇s exact test were used for statistical analyses.Results Compared with the control group,less patients in the treatment group experienced rebleeding （0/40 vs.5/38; x ^2 =5.624,P =0.018）; the treatment group also showed significantly improved indexes of liver function （all P 〈 0.05）.Conclusions GEVB after endoscopic treatment with early oral nutrition liquid administration can reduce in the early rebleeding risk and improve function and malnutrition status.