内镜下套扎联合普萘洛尔治疗肝硬化上消化道出血患者的临床疗效

Clinical efficacy of endoscopic ligation combined with propranolol in the treatment of patients with liver cirrhosis complicated with upper gastrointestinal bleeding

目的:观察内镜下套扎联合普萘洛尔治疗肝硬化上消化道出血患者临床疗效及对动力学指标的影响。方法:回顾性分析80例肝硬化上消化道出血患者临床资料,接受内镜套扎+普萘洛尔治疗的患者纳入观察组(n=40),仅接受内镜套扎治疗的患者纳入对照组(n=40)。比较两组患者临床疗效、止血时间、住院时间及再出血率,比较治疗前后血清相关因子及血流动力学指标变化情况。结果:观察组临床总有效率高于对照组(P<0.05);观察组止血时间、住院时间及再出血率均低于对照组(P<0.05);治疗3 d后,两组一氧化氮(NO)、胃泌素(GAS)、门静脉血流量(PVF)、脾静脉血流量(SVF)降低,且观察组低于对照组(P<0.05),两组超氧化物歧化酶(SOD)、前列腺素E2(PGE-2)升高,观察组高于对照组(P<0.05)。结论:内镜下套扎+普萘洛尔治疗肝硬化上消化道出血效果显著,能有效降低患者机体应激反应,改善血流动力学,保护上消化道黏膜。

Objective:To observe the clinical efficacy of endoscopic ligation combined with propranolol in the treatment of patients with liver cirrhosis complicated with upper gastrointestinal bleeding and its effects on dynamic indicators.Methods:The clinical data of 80 patients with liver cirrhosis and upper gastrointestinal bleeding were retrospectively analyzed.Patients who received endoscopic ligation+propranolol were included in the observation group(n=40),and patients who only received endoscopic ligation were enrolled as the control group(n=40).The clinical efficacy,hemostasis time,hospital stay and rebleeding rate were compared between the two groups,and the changes in serum-related factors and hemodynamic indicators were compared before and after treatment.Results:The total clinical effective rate in the observation group was higher than that in the control group(P<0.05).The hemostasis time,hospital stay and rebleeding rate in the observation group were shorter or lower than those in the control group(P<0.05).After 3 days of treatment,the levels of nitric oxide(NO),gastrin(GAS),portal venous flow(PVF)and splenic venous flow(SVF)in the two groups were decreased,and the observation group were lower than the control group(P<0.05).The levels of superoxide dismutase(SOD)and prostaglandin E2(PGE-2)were increased in the two groups,and the levels were higher in the observation group than those in the control group(P<0.05).Conclusion:Endoscopic ligation+propranolol has a significant efficacy in the treatment of liver cirrhosis with upper gastrointestinal bleeding,and it can effectively reduce the body's stress response,improve the hemodynamics,and protect the upper gastrointestinal mucosa.