硬化剂注射联合内镜下套扎术治疗肝硬化合并食管胃底静脉曲张破裂出血的效果

Effect of Sclerosing Agent Injection Combined with Endoscopic Ligation in the Treatment of Ruptured Bleeding of Esophagogastric Fundus Varices Combined with Liver Cirrhosis

目的:分析硬化剂注射联合内镜下套扎术治疗肝硬化合并食管胃底静脉曲张破裂出血(EGVB)的效果。方法:选取2022年1月—2023年10月瓮安县人民医院收治的肝硬化合并EGVB患者76例作为研究对象,根据随机数字表法分为对照组和观察组,各38例。对照组进行内镜下套扎术治疗,观察组进行硬化剂注射联合内镜下套扎术治疗。比较两组治疗效果、门静脉指标、并发症发生率、再出血率、复发率。结果:观察组总有效率高于对照组,差异有统计学意义(P=0.025)。治疗后,两组门静脉压、门静脉血流速度、门静脉血流量、门静脉内径低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。两组治疗后3 d再出血率比较,差异无统计学意义(P>0.05);观察组治疗后30 d再出血率低于对照组,差异有统计学意义(P=0.022);治疗后3个月,观察组复发率低于对照组,差异有统计学意义(P=0.012)。结论:硬化剂注射联合内镜下套扎术可改善肝硬化合并EGVB患者的门静脉指标,提高临床疗效,预防再出血及静脉曲张复发,且并发症少。

Objective:To analyze the effect of sclerosing agent injection combined with endoscopic ligation in the treatment of ruptured bleeding of esophagogastric fundus varices(EGVB)combined with liver cirrhosis.Methods:Seventy-six patients with liver cirrhosis combined with EGVB admitted to Qiannan Buyi and Miao Autonomous Prefecture Weng'an County People's Hospital from January 2022 to October 2023 were selected as the study subjects,and they were divided into the control group and the observation group according to the method of randomized numerical table,with thirty-eight cases in each group.The control group was treated with endoscopic ligation,and the observation group was treated with sclerosing agent injection combined with endoscopic ligation.The efficacy,portal vein index,complication rate,rebleeding rate,recurrence rate of the two groups were compared.Results:The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P=0.025).After treatment,the portal vein pressure,portal vein blood flow velocity,portal vein blood flow,and portal vein internal diameter of the two groups were lower than that before treatment,and the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Comparison of the complication rate between the two groups,the difference was not statistically significant(P>0.05).Comparison of the rebleeding rate 3 d after treatment between the two groups,the difference was not statistically significant(P>0.05);the rebleeding rate 30 d after treatment in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.022);three months after treatment,the recurrence rate of the observation group was lower than that of the control group,and the difference was statistically significant(P=0.012).Conclusion:Sclerosing agent injection combined with endoscopic ligation can improve portal vein indexes in patients with cirrhosis combined with EGVB,enhance clinical efficacy,prevent rebleeding and varicose vein recurrence,and have fewer complications.