|本期目录/Table of Contents|

[1]胡维杰,杨 建,汪晓骏.内镜下注射硬化剂联合药物防治 食管静脉曲张出血40例[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):109-111.
　HU Wei-jie,YANG Jian,WANG Xiao-jun.40 cases of endoscopic injection sclerotherapy combined with drugs on bleeding esophageal varices[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(02):109-111.
点击复制

内镜下注射硬化剂联合药物防治 食管静脉曲张出血40例()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第11卷
期数:
2009年02期
页码:
109-111
栏目:
出版日期:
2009-03-20

文章信息/Info

Title:
40 cases of endoscopic injection sclerotherapy combined with drugs on bleeding esophageal varices
文章编号:
1672-271X(2009)02-0109-03
作者:
胡维杰; 杨 建; 汪晓骏
解放军第81医院内镜室，江苏南京 210002
Author(s):
HU Wei-jie;  YANG Jian ; WANG Xiao-jun
Digestive Department,the 81th Hospital of PLA, Nanjing 210002,Jiangsu,China
关键词:
食管静脉曲张; 肝硬化; 出血; 硬化疗法; 奥曲肽; 心得安
Keywords:
Esophageal Varices; Cirrhosis; Hemorrhage; Sclerotherapy; Octreotide; Propranolol
分类号:
R573.2
DOI:
-
文献标志码:
A
摘要:
目的 回顾性分析内镜下注射硬化剂联合奥曲肽、心得安两种药物防治肝硬化食管静脉曲张出血的效果。方法 79例食管静脉曲张出血患者随机分为试验组和对照组。试验组(40例)在注射硬化剂前20 min皮下注射奥曲肽0.1 mg，后每1次/8 h，连续治疗4天后改为心得安20~40 mg长期口服。每隔1周做1次硬化治疗，3次为1个疗程；对照组(39例)单独应用硬化剂治疗，观察2组近期和远期再出血发生率。结果 试验组发生近期再出血1例，对照组6例；随访12个月中，试验组发生再出血5例，对照组12例。试验组近期与远期再出血发生率显著低于对照组(P均<0.05)。结论 内镜下注射硬化剂联合药物治疗食管静脉曲张出血与单纯内镜下注射硬化剂相比，前者可明显降低再出血发生率。
Abstract:
Objective To analyze the endoscopic injection sclerotherapy combined with Octreotide and Propranolol to prevent esophageal varices hemorrhage of cirrhosis Methods 79 cases of esophageal varices hemorrhage were randomly divided into case group and control group. Patients (40 cases) in case group were given by subcutaneous injection with Octreotide 0.1mg at 20 minutes before endoscopic injection sclerotherapy, then one injection per eight hours. After such 4-day-treatment, the patients were given Propranolol 20 to 40 milligram orally every day. Endoscopic injection sclerotherapy was given every other week, and 3 times for a course. Patients (39 cases) in control group were treated with endoscopic injection sclerotherapy only. Observe the difference of short-term and long-term re-bleeding rate between two groups.Results 2 patients in case group(2.5%)re-bleed in the short-term and 6 cases(15.4%)in control group. In the following up12 months, 5 patients (12.5%)in case group re-bleed and 12 cases(30.8%)in control group .The re-bleeding rate of case group is much lower than control group in the short-term and long-term (P<0.05).Conclusion Compared with endoscopic injection sclerotherapy only, Endoscopic injection sclerotherapy combined with drugs to treat esophageal varices hemorrhage can reduce the incidence of re-bleeding rate distinctively.

参考文献/References:

[1] 丁祥飞，陈佑江，文明波，等.门奇静脉断流术后再出血的预防及治疗[J].华南国防医学杂志，2007，21(5):54-55.
[2] 吴云林.消化内科新进展[M].北京:人民卫生出版社,2001:5-6.
[3] 董正芳,孟庆平,程留芳.食管静脉曲张再发出血的防治进展[J].医学综述,2007,13(12):924-926.
[4]Merkel C,Marin R,Angeli P,et al.Beta blockers in the prevention of aggrav-ation of esophageal varices in patients with cirrhosis and varices[J].Hepatology,2003,38(5):217.
[5]Lubel JS, Angus PW.Moderm management of portal hypertension[J].Inter Med J,2005,35(1):45-49.
[6]Patch D,Sabin CA,Goulis J,et al.A randomized controlled trial of medical therapy versus endoscopic ligation for the prevention of variceal rebleeding in patients with cirrhosis[J].Gastroenterology,2002,123(4):1013-1019.
[7]丁惠国,于中麟,胡中杰,等.预防食管胃静脉曲张再出血的内科治疗[J].中华消化内镜杂志,2000,17(4):228-229.
[8] 沈云志,赵建妹,蒋 伟,等.食管静脉曲张大出血硬化治疗后再出血分析[J].中华消化内镜杂志,2002,19(2):117-118.
[9] 李长政,程留芳,王志强,等.硬化治疗后曲张静脉内镜和超声内镜表现的演变[J].中华消化内镜杂志,2003,20(1):20-23.
[10] Bhasin DK,Malhi NJ.Variceal bleeding and portal hyperten- sion:much to learn,much to explore[J]. Endoscopy,2002,34(2):119-128.

相似文献/References:

[1]李会丽,李传生,崔正霞.门冬氨酸-鸟氨酸联合乳果糖灌肠治疗肝硬化肝性脑病疗效观察[J].医学研究与战创伤救治(原医学研究生学报),2012,14(02):190.
[2]冯青青,樊拖迎,李春安,等.乙型肝炎后肝硬化患者胆结石形成的机制探讨[J].医学研究与战创伤救治(原医学研究生学报),2011,13(03):217.
　FENG Qing-qing,FAN Tuo-ying,LI Chun-an,et al.Mechanism of gallstone formation in patients with cirrhosis after hepatitis B[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(02):217.
[3]姚 宁,姜朝晖,方晓明,等.腹腔镜胆囊切除术在肝硬化患者中的应用体会[J].医学研究与战创伤救治(原医学研究生学报),2010,12(02):115.
　YAO Ning,JIANG Zhao-hui,FANG Xiao-ming,et al.Experience of laparoscopic cholecystectomy in patients with hepatic cirrhosis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2010,12(02):115.
[4]司 芩,钱晓莉,仝 威,等.实时超声造影对肝硬化背景下占位病变的鉴别诊断[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):121.
　SI Qin,QIAN Xiao-li,TONG Wei,et al.Differential diagnosis of focal hepatic cirrhosis lesions using real-time contrast-enhanced ultrasound[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(02):121.
[5]顾生旺,蒋兆荣,万 利,等.腹水浓缩回输治疗顽固性肝硬化腹水 109例次疗效观察[J].医学研究与战创伤救治(原医学研究生学报),2008,10(01):22.
　GU Sheng-wang,JIANG Zhao-rong,WAN Li,et al.The curative effect of refractory ascites due to cirrhosis with ascitic concentration and reinfusion to abdominal cavity[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(02):22.
[6]乔 飞,汪茂荣,隋云华,等.肝硬化患者循环高动力状态与肝肾综合征的关系探讨[J].医学研究与战创伤救治(原医学研究生学报),2008,10(06):418.
　QIAO Fei,WANG Mao-rong,SUI Yun-hua,et al.The relationship between hyperkinetic circulatory state and genesis of hepatorenal syndrome in patients with liver cirrhosis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(02):418.
[7]梅 琪,虞 梅,张 菁,等.ARFI技术与血清铁、铁蛋白和肝纤维化四项检测在肝纤维化及肝硬化诊断中的相关性[J].医学研究与战创伤救治(原医学研究生学报),2014,16(03):241.[doi:10.3969/j.issn.1672-271X.2014.03.005]
　MEI Qi,YU Mei,ZHANG Jing,et al.Analysis of the correlation between ARFI and four indexes of serum liver fibrosis in the diagnosis of liver diseases[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(02):241.[doi:10.3969/j.issn.1672-271X.2014.03.005]
[8]何维新,周艳,范平,等.部分脾动脉栓塞治疗肝硬化脾功能亢进90例临床分析[J].医学研究与战创伤救治(原医学研究生学报),2014,16(05):490.[doi:10.3969/j.issn.1672-271X.2014.05.014]
　HE Wei-xin,ZHOU Yan,FAN Ping,et al.The clinical efficacy of the partial spleen artery embolization on the treatment of hypersplenism in 90 hepatic cirrhosis patients[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(02):490.[doi:10.3969/j.issn.1672-271X.2014.05.014]
[9]许永春,李婷婷,万 巧,等.内镜套扎术联合β-受体阻滞剂治疗食管静脉曲张破裂出血的临床疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2016,18(01):44.[doi:10.3969/j.issn.1672-271X.2016.01.013]
　XU Yong-chun,LI Ting-ting,WAN Qiao,et al.The clinical efficacy of emergency endoscopic ligation and β-adrenergic blocker for esophageal varices bleeding[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(02):44.[doi:10.3969/j.issn.1672-271X.2016.01.013]
[10]纪付红,林 红.肝硬化门静脉高压致上消化道出血的护理体会[J].医学研究与战创伤救治(原医学研究生学报),2016,18(03):319.[doi:10.3969/j.issn.1672-271X.2016.03.030]

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2013-11-20