硬化剂+套扎术对食管胃底静脉曲张破裂出血患者的疗效及对血流动力学的影响

Efficacy of sclerosing agent combined with ligation in the treatment of esophageal and gastric variceal bleeding and the influence on hemodynamics

目的探讨硬化剂+套扎术对食管胃底静脉曲张破裂出血患者的疗效及对血流动力学的影响。方法收集本院2020年1月-2021年12月收治的食管胃底静脉曲张破裂出血患者158例的资料行回顾性分析,按照治疗方法不同分为对照组(113例)和观察组(45例),对照组给予静脉曲张套扎治疗,观察组在此基础上给予硬化剂注射术治疗,观察两组患者临床疗效、血流动力学、再出血率、复发率和并发症情况。结果观察组的治疗有效率高于对照组(P<0.05)。两组患者中心静脉压(CVP)比较差异无统计学意义(P>0.05),观察组治疗后24 h(T1)、72 h(T2)时的门静脉压(PVP)低于对照组(P<0.05)。观察组的再出血率低于对照组(P<0.05);观察组的复发率低于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论食管胃底静脉曲张破裂出血患者使用硬化剂+套扎术治疗效果理想,可预防再出血,并有效改善患者血流动力学。

Objective To investigate the efficacy of sclerosing agent combined with ligation in the treatment of esophageal and gastric variceal bleeding,and the influence on hemodynamics.Methods The data of 158 patients with esophageal and gastric variceal bleeding who were treated in the hospital from January 2020 to December 2021 were retrospectively analyzed.According to different treatment methods,the patients were divided into control group(113 cases)and observation group(45 cases).Patients in the control group were treated with ligation,and patients in the observation group were treated with sclerosing agent injection on this basis.Clinical efficacy,hemodynamics,rebleeding rate,recurrence rate and complications were observed.Results The treatment response rate in the observation group(97.78%)was higher than that in the control group(86.73%)(P<0.05).There was no significant difference in CVP between the two groups(P>0.05).The observation group had lower PVP than the control group at T1 and T2(P<0.05).The rebleeding rate,recurrence rate and the incidence of complications in the observation group(2.22%,4.44%and 4.44%)were lower than those in the control group(17.70%,16.81%and 18.58%)(P<0.05).Conclusion Sclerosing agent combined with ligation is effective in the treatment of esophageal and gastric variceal bleeding,which can effectively improve hemodynamics.