胃镜下注射鱼肝油酸钠及组织粘合剂治疗食管静脉瘤出血30例临床评价

Cod Liver Oil Acid Sodium Injection Combined with Tissue Adhesive Under The Gastroscope in Treating Esophageal Varicose Vein Hemorrhage in 30 Cases

目的观察胃镜下注射鱼肝油酸钠联合组织粘合剂治疗食管静脉瘤出血的临床疗效及安全性。方法选取患者60例,随机分为观察组和对照组,每组30例。对照组胃镜下注射鱼肝油酸钠治疗,观察组胃镜下注射鱼肝油酸钠及组织粘合剂α-氰基丙烯酸烷基酯。结果观察组即时止血率为86.67%,高于对照组的63.33%(P<0.05);术后4周两组患者总有效率及食管静脉瘤缩小程度相当(P>0.05);观察组不良反应总发生率明显低于对照组(P<0.05),两组术后发热(<38℃)、胸痛或不适感发生率相当(P>0.05),观察组术后溃疡发生率明显低于对照组(P<0.05);观察组随访1年内再出血率低于对照组(P<0.05)。结论胃镜下注射鱼肝油酸钠及组织粘合剂即时止血效果明显,对肿瘤有一定消减作用,能有效防止术后再出血事件的发生,且安全性更高,值得临床推广。

Objective To observe the clinical efficacy and safety of cod liver oil acid sodium injection under gastroscoPe combined with tissue adhesive for the treatment of esoPhageal varicose vein hemorrhage. Methods 60 cases of esoPhageal varicose vein hemorrhage Patients were selected and randomly divided into the observation grouP and the control grouP,30 cases in each grouP. The observation grouP was given cod liver oil acid sodium injection under gastroscoPe theraPy combined with tissue adhesive alPha a cyano acrylic alkyl ester;the control grouP was given cod liver oil acid sodium injection under gastroscoPe theraPy alone. Results The instant hemostasis rate of the observation grouP was 86. 67% which was much higher than 63. 33% in the control grouP,with statistical significance （ P 〈 0. 05 ）;the esoPhageal vein tumors in the two grouPs after treatment had shrinked,with no statistical significance （ P 〉 0. 05 ）;the adverse reactions of the observation grouP was significantly lower than the control grouP （ P 〈 0. 05 ）;the PostoPerative fever （〈 38 ℃） , chest Pain or discomfort of the two grouP were almost the same （ P 〉 0. 05 ）; the incidence of ulcer in the observation grouP was lower than in the control grouP （ P 〈 0. 05 ）;the hemorrhage rate of the observation was obviously lower than the control grouP during the follow-uP （ P 〈 0. 05 ） . Conclusion The effect cod liver oil acid sodium injection under gastroscoPe combined with tissue adhesive alPha a cyano alkyl acrylate instant hemostatic is obvious,can effectively Prevent PostoPerative bleeding and is safer.