关键词: 肝硬化, 食管胃底静脉曲张破裂出血, 内镜曲张静脉套扎术, 生长抑素, 奥美拉唑, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of endoscopic variceal ligation (EVL) with intravenously administered somatostatin and omeprazole in the treatment of liver cirrhosispatients complicated withesophagogastric variceal bleeding (EVB). Methods 103 patients with liver cirrhosisand EVB were encountered in our hospital between January 2020 and January 2023, and were randomly divided into control (n=51) and observation (n=52) group. All patients in the two groups underwent EVL, and those in the observation were given intravenously omeprazole and somatostatin for 3 to 5 days until hemostasis, and all were followed-up for six months. Diameter and venous flow of portal vein and splenic vein were measured by color Doppler ultrasonography. Results Three patients (5.8%) in the observation group and eight patients (15.7%) in the control group died of emergent bleeding; blood transfusion volume, hemostasis time and hospitalization days in 49 survivals in the observation were (406.5±138.1)mL, (1.6±0.7)d and (5.8±1.5)d, much less or shorter than [(615.7±240.3)mL, (4.1±0.5)d and (9.1±1.7)d, respectively, P<0.05] in 43 survivals in the control; after treatment, serum albumin level in the observation was (33.4±5.3)g/L, much higher than [(31.3±4.6)g/L, P<0.05], and serum fibrinogen level was (4.2±0.5)g/L, much higher than [(3.8±0.4)g/L, P<0.05] in the control; peripheral blood platelet count, hematocrit and hemoglobin levels in the observation group were(219.3±20.1)×10⁹/L, (36.4±4.2)% and (109.6±6.1)g/L, all much higher than [(176.2±19.5)×10⁹/L, (31.7±4.3)% and (91.2±7.0)g/L, respectively, P<0.05] in the control; there were no significant differences as respect to diameters and blood flow of portal vein and splenic vein in the two groups (P>0.05); by end of six month follow-up, re-bleeding occurred in one patient (2.0%)in the observation group and survived, and it occurred in three patients (7.0%)in the control, and one (2.3%)of them died. Conclusion EVL and intravenous administration of somatostatin and omeprazole in dealing with patients with EVB is efficacious, which could stop intragastric bleeding definitely and effectively, and warrants further clinical investigation.

Key words: Liver cirrhosis, Esophagogastric variceal bleeding , Endoscopic variceal ligation, Somatostatin, Omeprazole, Therapy