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内镜静脉曲张结扎术与十四肽生长抑素治疗肝硬化食管静脉曲张破裂出血的疗效比较 被引量:3

A comparison between endoscopic variceal ligation and somatostatin for esophageal varices bleeding
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摘要 目的比较内镜静脉曲张结扎术与十四肽生长抑素在治疗肝硬化食管静脉曲张破裂出血中的效果方法将2003年1月至2006年4月广东省江门市中心医院消化科收治的80例肝硬化食管静脉曲张破裂出血患者分为内镜治疗组(40例)和十四肽生长抑素治疗组(40例)。内镜治疗组在内镜下用多环连发皮圈结扎器行静脉曲张结扎术(EVL),然后静脉滴注垂体后叶素7d;生长抑素治疗组先以十四肽生长抑素持续静脉滴注72h再以垂体后叶素静脉滴注持续4d。结果内镜治疗组中39例72h内止血(97.5%)。1个月内再出血4例(10%,其中1周内再出血3例),发生肝肾综合征1例,肝性脑病1例,死亡2例(5%)。生长抑素治疗组72h完全止血32例,1个月内再出血5例(12.5%),出现肝肾综合征5例(12.5%),P>0.05;肝性脑病6例(15%),P<0.05;死亡6例(15%),P>0.05。结论食管静脉曲张皮圈结扎治疗肝硬化食管静脉曲张破裂大出血优于生长抑素治疗,尽早EVL治疗能减少肝性脑病的发生。 Objective To evaluate the efficacy of endoscopic variceal ligation and somatostatin for esophageal varices bleeding. Methods Eighty patients with hepatic cirrhotic esophageal varices bleeding were allocated into two groups, forty in endoscopic variceal ligation(EVL) group and the others in somatostatin(stilamin) group. Results Initial hemostasis rates ( including emergency hemostasis and no bleeding for 72 hours) and one-month rebleeding rates in EVL group and somatostatin group were 97, 5% vs 80% ( P 〈 0. 05 ) and 10% vs 12.5% ( P 〉 0. 05 ). The hepatic encephalopathy rates were 2.5% vs 15%(P〈0.05), The mortality rates were 5% vs 15% (P 〉0.05). Conclusion Endoscopic variceal ligation is superior to somatostatin for hepatic cirrhotic esophageal varices bleeding, EVL can lower the rate of hepatic encephalopathy.
出处 《中国实用内科杂志》 CAS CSCD 北大核心 2007年第24期1929-1930,共2页 Chinese Journal of Practical Internal Medicine
关键词 食管和胃静脉曲张 肝硬化 内镜静脉曲张结扎术 十四肽生长抑素 Esophageal andgastric varices Cirrhosis of liver Endoscopic variceal ligation Somatostatin
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