关键词: 肝硬化, 食管胃底静脉曲张破裂出血, 内镜下套扎, 聚桂醇, 蛇毒血凝酶, 治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of endoscopic variceal ligation (EVL) with lauromacrogol and snake venom hemocoagulase injection in treating patients with hepatitis B liver cirrhosis (LC) complicated by esophagogastric variceal bleeding (EVB). Methods 98 patients with LC and EVB were enrolled in our hospital between January 2021 and January 2023, and we assigned them to underwent EVL in control, or to underwent EVL with lauromacrogol and snake venom hemocoagulase injection in observation group. All patients were followed-up for 6 months. Portal vein pressure (PVP), portal vein diameter (PVD), portal vein velocity (PVV) and portal vein flow (PVF) were measured by color Doppler ultrasonography. Serum gastrin (GAS), glucagon (GLC) and motilin (MTL) levels were detected by ELISA. Results The 7-day mortality were 16.3% and 18.4%(P>0.05) in the observation and control group, and successful hemostasis in the observation was 65.3%, much higher than 53.1%(P<0.05) in the control; after treatment, PVP, PVV and PVF in the observation were (21.4±2.7)mmHg, (17.9±2.4)cm/s and (552.1±138.4)mL/min, all significantly lower than [(24.5±2.8)mmHg, (21.9±2.2)cm/s and (735.2±159.7)mL/min, respectively, P<0.05] in the control; serum GLC and MTL levels were (45.6±7.6)ng/L and (214.6±19.7)ng/L, both significantly lower than [(56.3±8.4)ng/L and (248.2±22.3)ng/L, respectively, P<0.05] in the control group; incidence of adverse effect, such as retrosternal pain in the observation was 24.4%, much higher than 2.5%, while rebleeding was 4.9%, much lower than 25.0%(P<0.05) in the control group. Conclusion The efficacy of EVL with Lauromacrogol and snake venom hemocoagulase injection in the treatment of LC with EVB is promising, with low rebleeding rate, and warrants further investigation.

Key words: Liver cirrhosis, Esophagogastric variceal bleeding, Endoscopic variceal ligation, Lauromacrogol, Snake venom hemocoagulase, Therapy