介入治疗老年胰源性门脉高压症患者并发消化道出血的临床价值

Clinical value of interventional treatment in pancreatogenic portal hypertension complicated by gastrointestinal bleeding in elderly patients

目的探讨介入技术在老年胰源性门脉高压症(pancreatic portal hypertension,PPH)并发消化道出血中的治疗价值.方法选择2002-05/2016-05新昌县人民医院收治的65例老年PPH并发消化道出血患者,根据治疗方案不同,分为内镜治疗的对照组,和介入治疗的观察组,然后将两组患者的止血时间、输血量、1 wk内再次出血等指标及疗效情况进行比较.结果观察组患者的平均止血时间、平均输血量、1 wk内再出血发生率明显低于对照组(8.1h±1.5h vs 12.9h±1.3h、620mL±100mL vs 750mL±110mL、6.67%vs 14.29%),差异均有统计学意义(P<0.05);观察组患者的治疗总有效率为90%,显著高于对照组患者的68.57%,差异有统计学意义(P<0.05);两组患者在上腹部疼痛、脾脓肿、死亡等发生率上无明显差异,无统计学意义(P>0.05).结论老年PPH并发消化道出血的患者中,给予介入治疗方案,具有止血确切可靠的特点,提高治疗有效率,为该病的临床治疗提供更多参考.

AIM To investigate the value of interventional techniques in the treatment of gastrointestinal hemorrhage in elderly patients with pancreatogenic portal hypertension.METHODS Sixty-five patients with pancreatogenic portal hypertension complicated by gastrointestinal bleeding treated at the People＇s Hospital of Xinchang County from May 2002 to May 2016 were included and divided into a control group to receive endoscopic treatment or an observation group to receive interventional treatment. Time to hemostasis, blood transfusion, re-bleeding within 1 wk and other indicators were compared between the two groups. RESLIL TS The average time to hemostasis was significantly shorter in the observation group than in the control group （8.1 h ±1.5 h vs 12.9 h ± 1.3 h, P 〈 0.05）. The mean volume of blood transfusion was significantly lower in the observation group than in the control group （620 mL ＋ 100 mL vs 750 mL ＋ 110 mL, P 〈 0.05）. The incidence of rebleeding within 1 wk was significantly lower in the observation group than in the control group （6.67% vs 14.29%, P 〈 0.05）. The total effective rate was significantly lower in the observation group than in the control group （90% vs 68.57%, P 〈 0.05）. There was no significant difference in the incidence of upper abdominal pain, spleen abscess, or death between the two groups （P 〉 0.05）. CONCLUSION In elderly patients with pancreatic portal hypertension complicated by gastrointestinal bleeding, interventional treatment can effectively achieve hemostasis and improve the efficiency of treatment.