摘要
目的 比较内镜下食管静脉曲张套扎术(EVL)及内镜下硬化剂(EIS)治疗肝硬化伴消化道出血的临床疗效。方法 选取河南科技大学第一附属医院2022年6月至2025年1月收治的102例肝硬化伴消化道出血患者,通过随机数字表法分为研究组与对照组,每组各51例。对照组采用EIS治疗,研究组采用EVL治疗。比较两组治疗前后静脉曲张情况、出血情况、实验室指标、肝功能、血小板计数及临床症状改善情况。结果 术后1 d复查,两组静脉曲张减小或消失、无再出血情况比较,差异均无统计学意义(P> 0.05);术后30 d,研究组静脉曲张减小或消失率(90.20%)、无再出血率(98.04%)均高于对照组(72.55%、80.39%)(P<0.05)。术后1 d复查,两组血红蛋白(Hb)、白蛋白(Alb)、凝血酶原时间(PT)和国际标准化比值(INR)比较,差异均无统计学意义(P>0.05);术后30 d,研究组Hb、Alb、PT、INR指标水平均优于对照组(P<0.05)。术后1 d复查,两组腹痛缓解率、黄疸改善率比较,差异均无统计学意义(P>0.05);术后30 d,研究组腹痛缓解率(94.12%)、黄疸改善率(98.04%)均高于对照组(78.43%、82.35%)(P<0.05)。术后1 d及术后30 d,两组谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBil)水平差异均无统计学意义(P>0.05)。术后1 d,两组血小板(PLT)计数差异无统计学意义(P>0.05)。术后30 d,研究组PLT计数较对照组升高(P<0.05)。术后1 d复查,两组C-反应蛋白(CRP)、白细胞(WBC)计数比较,差异均无统计学意义(P>0.05);术后30 d,研究组CRP、WBC较对照组降低(P<0.05)。结论 采用EVL治疗肝硬化伴消化道出血效果优于EIS,可有效缓解静脉曲张,避免再出血,改善患者临床症状及肝功能状态。
Objective To compare the clinical effects of endoscopic esophageal variceal ligation(EVL)and endoscopic sclerotherapy(EIS)in the treatment of liver cirrhosis with gastrointestinal bleeding.Methods A total of 102 patients with liver cirrhosis and gastrointestinal bleeding admitted to the hospital from June 2022 to January 2025 were selected and divided into the study group and the control group by the simple random number table method,with 51 cases in each group.The control group was treated with EIS and the study group was treated with EVL.The improvement of varicose veins,bleeding,laboratory indexes,liver function,platelet count and clinical symptoms in the 2 groups before and after the treatment were analyzed.Results 1 day after the operation,during the reexamination,there was no statistically significant difference in the reduction or disappearance of varicose veins and no rebleeding between the 2 groups(P>0.05).At 30 days after the operation,the reduction or disappearance rate of varicose veins(90.20%)and the rate of no rebleeding(98.04%)in the study group were both higher than those in the control group(72.55%,80.39%)(P<0.05).1 day after the operation,during the reexamination,there were no statistically significant differences in the levels of hemoglobin(Hb),albumin(Alb),prothrombin time(PT)and international normalized ratio(INR)between the 2 groups(P>0.05).At 30 days after the operation,the levels of Hb,Alb,PT and INR indicators in the study group were all better than those in the control group(P<0.05).1 day after the operation,during the reexamination,there was no statistically significant difference in the relief of abdominal pain and the improvement of jaundice between the 2 groups(P>0.05).At 30 days after the operation,the remission rate of abdominal pain(94.12%)and the improvement rate of jaundice(98.04%)in the study group were both higher than those in the control group(78.43%,82.35%)(P<0.05).At one day and 30 days after the operation,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil)in both groups were no statistically significant difference(P>0.05).At one day after the operation,there was no statistically significant difference in the platelet count(PLT)between the two groups(P>0.05).At 30 days after the operation,the PLT count in the study group was higher than that in the control group(P<0.05).One day after the operation,during the reexamination,there was no statistically significant difference in the C-reactive protein(CRP)and white blood cell count(WBC)between the two groups(P<0.05).At 30 days after the operation,the CRP,WBC count in the study group were lower than those in the control group(P<0.05).Conclusion EVL is better than EIS in the treatment of liver cirrhosis with gastrointestinal bleeding,and can effectively relieve varicose veins,avoid rebleeding,and improve clinical symptoms and liver function.
作者
侯照阳
姚国良
王树鹏
范永刚
HOU Zhaoyang;YAO Guoliang;WANG Shupeng;FAN Yonggang(Clinical Medical School of Henan University of Science and Technology,Luoyang Henan 471003,China;Department of Hepatobiliary and Pancreatic Oncology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471003,China)
出处
《新疆医科大学学报》
2025年第5期652-656,共5页
Journal of Xinjiang Medical University
基金
河南省医学科技攻关计划项目(LHGJ20230445)。
关键词
肝硬化
消化道出血
胃镜下套扎
硬化剂
cirrhosis
gastrointestinal bleeding
gastroscopic ligation
sclerosant
