内镜下套扎联合药物注射治疗肝硬化合并上消化道出血的有效性及安全性

Effectiveness and safety of endoscopic ligation combined with drug injection in the treatment of cirrhosis complicated with upper digestive hemorrhage

目的探讨内镜下套扎联合药物注射治疗肝硬化合并上消化道出血的有效性以及安全性。方法选取医院2015年1月～2017年12月接收的50例肝硬化合并上消化道出血患者,将其随机分为观察组与对照组,各25例,对照组患者接受医院的保守治疗,观察组患者在保守治疗的基础上进行内镜下套扎联合药物注射治疗。对两组患者的止血时间、住院时间、再出血与治疗前后血流动力学等相关指标进行比较。结果观察组患者的输血量少于对照组,止血时间、症状改善时间、住院时间均短于对照组,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后的门静脉血流量、脾静脉血流量均少于对照组(P<0.05);观察组患者的再出血率低于对照组,差异有统计学意义(P<0.05)。结论对肝硬化合并上消化道出血患者实施内镜下套扎联合药物注射治疗,具有显著疗效,使患者的静脉曲张血流动力学得到有效改善,并降低患者的再出血率。

Objective To explore the effectiveness and safety of endoscopic ligation combined with drug injection in the treatment of cirrhosis complicated with upper digestive hemorrhage.Methods A total of 50 patients with cirrhosis and upper digestive hemorrhage admitted to our hospital from January 2015 to December 2017 were enrolled,they were randomly divided into observation group and control group with 25 cases in each group,patients in control group received conservative treatment in hospital,patients in observation group received endoscopic ligation combined with drug injection on the basis of conservative treatment.The hemostasis time,hospitalization time,rebleeding and hemodynamics before and after treatment were compared between the two groups.Results The amount of blood transfusion in the observation group was less than that in the control group,and the hemostasis time,symptom improvement time and hospitalization time were shorter than those in the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statiscally significant(P<0.05).The portal venous blood flow and splenic venous blood flow in the observation group were fewer than those in the control group(P<0.05).The re-bleeding rate in the observation group was lower than that in the control group,the difference was statiscally significant(P<0.05).Conclusion Endoscopic ligation combined with drug injection is effective in the treatment of cirrhosis complicated with upper gastrointestinal hemorrhage,which can effectively improve the varicose hemodynamics and reduce the probability of re-bleeding.