内镜下套扎术联合聚桂醇硬化术对食管-胃底静脉曲张出血患者再出血的防治作用

Clinical effect of endoscopic ligation combined with lauromacrogol sclerosis on rebleeding in patients with esophageal and gastric variceal bleeding

摘要:

目的 探讨内镜下套扎术联合聚桂醇硬化术对食管-胃底静脉曲张出血（EGVB）患者再出血的防治作用。方法 选取2018年9月－2020年9月解放军总医院第三医学中心EGVB患者120例，依据手术方法不同分为套扎组（n = 60）和套聚组（n = 60）。套扎组行内镜下套扎术，套聚组行内镜下套扎术联合聚桂醇硬化术。比较两组患者止血效果、死亡率、血红蛋白水平、再出血及并发症情况。结果 两组患者及时止血率和死亡率比较，差异无统计学意义（P > 0.05）；套聚组止血时间短于套扎组（P < 0.05）；套扎组和套聚组术后1和3 d血红蛋白水平高于术前，套聚组术后1和3 d血红蛋白水平高于套扎组（P < 0.05）；套聚组再出血率低于套扎组（P < 0.05）；两组患者并发症率比较，差异无统计学意义（P > 0.05）。结论 内镜下套扎术联合聚桂醇硬化术对EGVB患者具有更快的止血效果，有利于恢复血红蛋白水平，对再出血的防治作用更佳，且安全性好。

Abstract:

Objective To discuss the effect of endoscopic ligation combined with lauromacrogol sclerosis on rebleeding in patients with esophageal and gastric variceal bleeding (EGVB).Methods 120 patients with EGVB in the Third Medical Center of PLA General Hospital from September 2018 to September 2020 were selected, and they were divided into ligation group (n = 60) and nebulized group (n = 60) according to different surgical methods. The ligation group was given endoscopic ligation, the nebulized group was given endoscopic ligation combined with lauromacrogol sclerosis, the hemostatic effect, death rate, hemoglobin level, rebleeding and complications were compared between the two groups.Results There was no significant difference in timely hemostasis rate and mortality between the two groups (P > 0.05). The hemostasis time in nebulized group was shorter than that in the ligation group (P < 0.05). The hemoglobin level at 1 and 3 days after surgery in ligation group and nebulized group was higher than those before the surgery, and the hemoglobin level at 1 and 3 days after surgery in nebulized group was higher than those of ligation group (P < 0.05). The rebleeding rate in nebulized group was lower than that of ligation group (P < 0.05). There was no significant difference in the complication rate between the two groups (P > 0.05).Conclusion Endoscopic ligation combined with lauromacrogol sclerosis has the faster hemostasis effect in patients with EGVB, it is helpful to the recovery of hemoglobin level, and it has the better prevention and treatment effect on rebleeding, and it has the good safety.