关键词: 肝硬化, 食管胃底静脉曲张破裂出血, 内镜下套扎序贯硬化剂栓塞, 门脉血流动力学, 治疗

Abstract: Objective To investigate the efficacy of endoscopic sequential variceal 1igation plus sclerotherapy （EVLS） in treatment of patients with hepatitis B-induced liver cirrhosis （LC） complicated by esophageal gastric varices bleeding （EGVB）. Methods A retrospective analysis of 80 patients with hepatitis B-induced liver cirrhosis complicated by EGVB were recruited in our hospital between February 2016 and October 2017,and the patients were randomly divided into observation （n=40） and control group （n=40）. All patients received conventional hemostasis therapy,and 40 patients in observation group received EVLS at the base of conventional supporting therapy. Serum gastrin （GAS） and glucagon （GLC） levels were detected by ELISA. The portal venous pressure （PVP）,portal vein diameter （PVD）,portal vein velocity （PVV） and portal vein blood flow （PVF） were detected by ultrasound. All patients were followed-up for 12 months. Results At the end of 2 weeks,three （7.5%） in observation and 10（25.0%） in the control died,and the effective hemostatic rates were 92.5% vs. 75.0% （P<0.05） in the two groups;the PVP,PVD and PVF in the observation were（22.5±1.6） mmHg,（11.7±0.4） mm and （546.2±131.6） ml/min,significantly lower than （25.3±2.0） mmHg,（13.8±0.5） mm and （742.6±162.8） ml/min （P<0.05） in the control;serum GAS and GLC levels in the observation were （72.5±10.4） ng/L and （52.4±7.8）ng/L,significantly lower tha （95.8±14.7） ng/L and （59.6±8.9） ng/L （P<0.05） in the control;at the end of 12 month follow-up,2（5.4%） patients in the observation,while 8（26.7%,x2=4.114,P=0.043） patients in the control had re-bleeding. Conclusion The application of EVLS at the base of conventional supporting therapy in the treatment of patients with liver cirrhosis with EGVB is highly efficacious and safe, which warrants further investigation.

Key words: Liver cirrhosis, Esophageal gastric varices bleeding, Endoscopic sequential variceal 1igation plus sclerotherapy, Portal hemodynamics, Therapy