内镜套扎术联合奥美拉唑、奥曲肽治疗食管静脉曲张出血的疗效及安全性

目的:探究内镜套扎术联合奥美拉唑、奥曲肽治疗食管静脉曲张出血的疗效及安全性。方法:选取2014年5月至2016年5月于我院诊治的肝硬化合并食管静脉曲张出血患者127例,分为研究组和对照组。对照组在常规治疗的基础上予以奥美拉唑和奥曲肽治疗,研究组则在对照组基础上予以内镜下食管静脉曲张套扎术(EVL)治疗。分析比较两组患者的临床疗效、住院情况、不良反应的发生情况及治疗后再出血率。结果:研究组所有患者的均成功完成手术,未出现大出血情况,对照组有10例患者表现为呕血和黑便,其中1例患者转为手术治疗。治疗后,研究组的临床总有效率显著高于对照组(P0.05)。治疗期间,研究组的止血时间、输血量、住院天数和住院费用均显著少于对照组(P0.05),研究组和对照组分别有10例和7例患者出现了恶心呕吐、食管异物感、头昏、心悸、腹痛腹胀、大便次数增多和发热等不良反应,其中对照组的大便次数增多的发生率显著高于研究组(P0.05),而其余不良反应发生率和不良反应总发生率比较差异无统计学意义。治疗后1年随访时间内,无死亡患者,研究组在第0.5、1、3、6、12个月的再出血率均显著低于对照组(P0.05)。结论:内镜套扎术联合奥美拉唑、奥曲肽治疗食管静脉曲张出血的临床疗效明显,能够有效、快速止血,缩短住院天数,降低住院费用和再出血率,且安全性高。

The Efficacy and Safety of Endoscopic Esophageal Varix Ligation combined with Omeprazole and Octreotide in the Treatment of Esophageal Variceal Bleeding

ABSTRACT Objective: To explore the efficacy and safety of endoscopic esophageal varix ligation(EVL) combined with omepra- zole and octreotide in the treatment of esophageal variceal bleeding. Methods: 127 patients with cirrhosis complicated with esophageal variceal hemorrhage diagnosed and treated in our hospital from May 2014 to May 2016 were divided into the study group and the control group. The control group was treated with omeprazole and octreotide on the basis of conventional therapy, while the study group was treated with endoscopic esophageal variceal ligation (EVL) on the basis of control group. The clinical efficacy, hospitalization condition, incidence of adverse reactions and rebleeding rate after treatment of the two groups were analyzed. Results: All the patients in the study group were successfully operated. In the control group, 10 patients showed hematemesis and melena, among which 1 patient was treated with surgery. After treatment, the clinical efficacy of the study group was superior to the control group, and the difference was statistically significant (P<0.05). During the treatment period, the hemostasis time, blood transfusion time, hospital stay and hospitalization expenses of the study group were significantly lower than those of the control group (P<0.05). In the study group and the control group, 10 cases and 7 cases respectively had nausea and vomiting, esophageal foreign body sensation, dizziness, palpitations, pain, bloating, increased faeces frequency, fever and other adverse reactions, and the incidence of increased faeces frequency of control group was significantly higher than that of the study group (P<0.05), but the incidence of other adverse reactions and the total incidence showed no significant difference between two groups(P>0.05). The rate of rebleeding was significantly lower in the study group at 0.5, 1, 3, 6 and 12 months after treatment than those in the control group(P<0.05). Conclusion: Endoscopic ligation combined with omeprazole and octreotide was effec- tive in the treatment of esophageal variceal bleeding, which could be effective, rapid hemostasis, reduce the hospital stay, hospitalization cost and rebleeding rate with high safety.