内镜套扎术联合西药治疗肝硬化食管静脉曲张破裂出血的效果及对肝功能、血管内皮损伤的影响

Effect of Endoscopic Variceal Ligation Combined with Western Medicine for Esophageal Variceal Bleeding in Liver Cirrhosis and Its Influence on Liver Function and Vascular Endothelial Injury

目的探讨内镜套扎术联合西药治疗肝硬化食管静脉曲张破裂出血的效果及对肝功能、血管内皮损伤的影响。方法选取2018年3月-2020年1月郑州市第九人民医院消化内科90例肝硬化食管静脉曲张破裂出血患者,按随机数字法分为对照组和研究组,各45例。两组均进行内镜套扎术治疗,研究组在术后服用普萘洛尔。观察比较1个月后两组疗效、肝功能及血管内皮损伤情况。结果两组食管静脉曲张消失成功率无统计学意义(P>0.05)。研究组食管静脉曲张复发及再出血率低于对照组(P<0.05)。治疗后研究组ALT及AST水平低于对照组(P<0.05)。治疗后研究组一氧化氮水平低于对照组(P<0.05),内皮素-1水平高于对照组(P<0.05)。结论内镜套扎术联合西药可有效降低肝硬化食管静脉曲张破裂出血患者复发及再出血率,改善其肝功能并降低对血管内皮的损伤,值得推荐使用。

Objective To investigate the effect of endoscopic variceal ligation combined with Western medicine for esophageal variceal bleeding in liver cirrhosis and its influence on liver function and vascular endothelial injury.Methods 90 liver cirrhosis patients with esophageal variceal bleeding in Ninth People′s Hospital of Zhengzhou from March 2018 to January 2020 were enrolled, and divided into two groups by random number table methods, each with 45 cases.Both groups received endoscopic variceal ligation, based on this, study group received propranolol hydrochloride.One month later, the curative effect, liver function and vascular endothelial injury of two groups were observed.Results The success rate of disappearance of esophageal varices had no significant difference between groups(P>0.05).The rate of esophageal varices recurrence and rebleeding in study group was lower than that in control group(P<0.05).ALT and AST levels in study group were lower than those in control group(P<0.05).After treatment, nitric oxide level in study group was lower than that in control group(P<0.05),and the level of endothelin-1 was higher than that in control group(P<0.05).Conclusion Application of endoscopic variceal ligation combined with Western medicine for esophageal variceal bleeding in liver cirrhosis can effectively reduce the rate of esophageal varices recurrence and rebleeding, ameliorate the liver function and vascular endothelial injury, which is worthy of clinical promotion.