内镜下套扎术联用生长抑素不同时程治疗食管静脉曲张破裂出血的效果分析

Effect of endoscopic variceal ligation combined with somatostatin of various duration in treatment of esophageal variceal bleeding

目的探讨内镜下套扎术联用生长抑素不同时程治疗食管静脉曲张破裂出血的效果。方法选择我院2008年1月～2018年5月收治的180例食管静脉曲张破裂出血患者,经内镜下套扎术后根据生长抑素使用天数分成三组:生长抑素3 d组、生长抑素5 d组和生长抑素7 d组;分析7 d内、7～14 d和7～42 d内再出血率、总止血率、成本、成本-效果比、并发症和副反应发生率。结果生长抑素3 d组、生长抑素5 d组和生长抑素7 d组的7 d内再出血率、7～14 d内再出血率和7～42 d内再出血率比较,差异均无统计学意义(P>0.05);三组总止血率比较,差异无统计学意义(P>0.05);三组的成本及成本-效果比比较,生长抑素3 d组的成本及成本-效果比均为最低;三组的并发症及副反应发生率比较,差异均无统计学意义(P>0.05)。结论内镜下套扎术联用生长抑素3 d能达到有效时程,其效果与5 d时程及7 d时程效果相同,不必延长使用时间。

Objective To explore the effect of endoscopic variceal ligation(EVL)combined with somatostatin of various duration in treatment of esophageal variceal bleeding(EVB).Methods A total of 180 patients with EVB who were treated in our hospital from January 2008 to May 2018 were divided into 3 groups according to the number of days of somatostatin after endoscopic ligation:somatostatin 3 days group;somatostatin 5 days group and somatostatin 7 days group.The rebleeding rate,total hemostasis rate,cost,cost-effectiveness ratio,incidence of complications and side effects were analyzed within 7 days,7-14 days,and 7-42 days.Results There were no significant differences in rebleeding rates within 7 days,7-14 days,and 7-42 days among the three treatment groups(P>0.05).There was no significant difference in the total hemostasis rates among the three groups(P>0.05).The cost and cost-effectiveness ratio of the somatostatin 3 days group was the lowest among the three group;there was no significant difference in the incidence of complications and side effects among the three groups(P>0.05).Conclusion Endoscopic ligation combined with somatostatin for 3 days can achieve an effective result,and the effect is the same as those of the 5 days and 7 days courses.Therefore,it is not necessary to extend the use time of somatostatin.