内镜下组织胶联合聚桂醇治疗肝硬化静脉曲张出血患者的疗效及预后观察

The curative effect and prognosis of endoscopic tissue glue combined with lauromacrogol therapy for patients with cirrhosis and variceal bleeding

目的:研究内镜下组织胶联合聚桂醇治疗肝硬化静脉曲张出血患者的疗效及预后情况。方法:选择榆林市第一医院2015年3月~2018年2月期间进行内镜下止血治疗的肝硬化静脉曲张出血患者进行回顾性研究,根据病史资料分为接受聚桂醇-组织胶-聚桂醇方案内镜下止血的观察组、接受碘油-组织胶-碘油内镜下止血的对照组。治疗后观察止血时间并比较血常规指标、应激相关激素、氧化相关介质、炎症相关介质的差异。结果:观察组的平均止血时间短于对照组,治疗24h后的血红蛋白含量、红细胞压积均高于对照组,血清中GAS、AT-Ⅱ、NE、E、Cor、MDA、LPO、NO、iNOS、p38MAPK、NF-κB、TNF-α、IL-6、IL-8的含量低于对照组。结论:内镜下组织胶联合聚桂醇治疗肝硬化静脉曲张出血的止血效果优于组织胶联合碘油治疗,同时也能减轻氧化应激反应及炎症反应。

Objective：To study the curative effect and prognosis of endoscopic tissue glue＋lauromacrogol therapy for patients with cirrhosis and variceal bleeding.Methods：Patients with cirrhosis and variceal bleeding who underwent endoscopic hemostasis in the First Hospital of Yulin between March 2015 and February 2018 were retrospectively studied and divided into the observation group who accepted endoscopic hemostasis by lauromacrogol-tissue glue-lauromacrogol solution and the control group who accepted endoscopic hemostasis by lipiodol-tissue glue-lipiodol solution according to the history data.After treatment,the hemostasis time was observed,and the differences in blood routine indicators,stress-related hormones,oxidation-related mediators and inflammation-related mediators were compared.Results：The mean hemostasis time of observation group was shorter than that of control group,hemoglobin and hematokrit after 24 hours of treatment were higher than those of control group,and serum GAS,AT-Ⅱ,NE,E,Cor,MDA,LPO,NO,iNOS,p38 MAPK,NF-κB,TNF-α,IL-6 and IL-8 levels were lower than those of control group.Conclusion：Endoscopic tissue glue combined with lauromacrogol therapy is better than tissue glue combined with lipiodol therapy in hemostasis,and can also relieve the oxidative stress response and inflammatory response.