改良三腔二囊管压迫止血联合内镜介入治疗食管-胃底静脉曲张破裂出血患者临床疗效和安全性分析

Clinical Efficacy and Safety of the Modified Sengstaken-blakemore Tube Compression Hemostasis Combined with Endoscopic Interventional Therapy in the Treatment of Patients with Esophageal-gastric Varices Bleeding

目的分析改良三腔二囊管压迫止血联合内镜介入治疗食管-胃底静脉曲张破裂出血患者的临床疗效和安全性。方法选取2017年4月-2020年2月本院收治的120例食管-胃底静脉曲张破裂出血患者为研究对象。按治疗方法分为对照组40例和观察组80例。观察组采用改良三腔二囊管压迫止血联合内镜介入治疗,对照组采用单纯内镜介入治疗。比较2组内镜治疗后不同时点的止血情况、术后72 h心率、血压、血红蛋白变化及并发症发生情况。结果观察组术后30 min、1、5 h止血率均显著高于对照组(P<0.05)。与术前相比,2组术后72 h心率显著降低,血压及血红蛋白较显著升高,且观察组变化更显著(P<0.05,P<0.01)。观察组术后胸痛、胸闷、鼻黏膜受损、呼吸困难发生率显著低于对照组(P<0.01)。结论采用改良三腔二囊管压迫止血联合内镜介入治疗食管-胃底静脉曲张破裂出血患者可提高其止血率,降低并发症发生率。

Objective To analyze the clinical efficacy and safety of the modified Sengstaken-Blakemore tube compression hemostasis combined with endoscopic interventional therapy in the treatment of patients with esophageal-gastric varices bleeding.Methods A total of 120 patients with esophageal gastric varices bleeding treated in our hospital from April 2017 to February 2020 were selected as the research subjects.According to different treatment methods,they were divided into control group(n=40)and observation group(n=80).The observation group was treated with modified Sengstaken-Blakemore tube compression hemostasis combined with endoscopic interventional therapy,while the control group was treated with simple endoscopic intervention.Hemostasis at different time points,heart rate,blood pressure,hemoglobin changes and complications at 72 h after endoscopic treatment were compared between the two groups.Results The hemostatic rate of the observation group at 30 min,1 h,and 5 h after treatment was significantly higher than that of the control group(P<0.05).Compared with those before treatment,the heart rate of the two groups at 72 h after treatment was significantly decreased,while blood pressure and hemoglobin were significantly increased,and the changes in the observation group were more significant(P<0.05,P<0.01).The incidence of postoperative chest pain,chest tightness,nasal mucosa damage and dyspnea in the observation group was significantly lower than that in the control group(P<0.01).Conclusion The modified Sengstaken-Blakemore tube compression hemostasis combined with endoscopic interventional therapy in the treatment of patients with esophageal-gastric varices bleeding can increase the rate of hemostasis and reduce the incidence of complications.