聚桂醇硬化注射术联合生长抑素治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者疗效研究*

doi:10.3969/j.issn.1672-5069.2026.03.016

摘要/Abstract

摘要： 目的探讨聚桂醇硬化注射术联合生长抑素治疗乙型肝炎肝硬化(LC)并发食管胃底静脉曲张破裂出血(EGVB)患者的疗效。方法 2023年5月～2025年5月我院收治的94例LC并发EGVB患者,被随机分为对照组47例和联合治疗组47例,给予对照组内科综合治疗,包括给予注射用生长抑素静脉泵入,维持治疗3～5天。联合组在对照组治疗的基础上给予急诊胃镜下聚桂醇硬化注射术治疗。采用放射免疫法检测血清胃动素(MTL)、生长抑素(SS)和纤维蛋白原(FIB)水平,使用血液分析仪检测凝血酶原时间(PT)。结果在出血急性期,对照组死亡2例,联合组死亡1例;联合组输血量为(1.9±0.3)U,显著少于对照组【(4.1±0.7)U,P＜0.05】,止血时间和住院时间分别为(15.3±4.5) h和(12.4±2.9)d,均显著短于对照组【分别为(22.6±5.8)h和(16.8±3.5)d,P＜0.05】;止血后,联合组生存者血清MLT和SS水平分别为(210.3±16.2)ng/L和(69.4±11.0)ng/L,均显著低于对照组【分别为(285.2±19.3)ng/L和(93.5±14.2)ng/L,P＜0.05】,而血清FIB水平为(2.7±0.9)g/L,显著高于对照组【(2.0±0.5)g/L,P＜0.05】;联合组2 w、1 m和3 m再出血率分别为0.0%、0.0%和2.2%,均显著低于对照组的11.1%、17.8%和31.1%(P＜0.05)。结论采取聚桂醇硬化注射术联合生长抑素治疗LC并发EGVB患者可快速控制急性出血,缩短止血时间,调节胃肠激素平衡,值得开展临床研究。

关键词: 肝硬化, 食管胃底静脉曲张破裂出血, 聚桂醇硬化注射术, 生长抑素, 治疗

Abstract: Objective The aim of this study was to investigate endoscopic lauromacrogol sclerosis injection with combination of intravenous pumping of somatostatin in treatment of patient with hepatitis B-induced liver cirrhosis (LC) and esophageal and gastric variceal bleeding (EGVB). Methods A total of 94 patients with hepatitis B-induced LC and EGVB were encountered in our hospital between May 2023 and May 2025, and were randomly assigned to receive internal comprehensive supporting treatment, including intravenous pumping of somatostatin for 3 to 5 days in 47 cases for control, or underwent endoscopic lauromacrogol sclerosis injection at basis of supporting therapy in the control in another 47 cases. Serum motilin (MTL), somatostatin (SS) and fibrinogen (FIB) levels were detected by radioimmunoassay, and prothrombin time (PT) was detected by blood analyzer. Results Two patients in the control and one in the combination group died of emergent bleeding in our series; total blood transfusion volume in the combination group was (1.9±0.3)U, much less than [(4.1±0.7)U, P＜0.05], and hemostasis time and hospital stay were (15.3±4.5) h and (12.4±2.9)d, both much shorter than [(22.6±5.8)h and (16.8±3.5)d, respectively, P＜0.05] in the control; after hemostasis, serum MLT and SS levels were (210.3±16.2)ng/L and (69.4±11.0)ng/L, both significantly lower than [(285.2±19.3)ng/L and (93.5±14.2)ng/L, respectively, P＜0.05], while serum FIB level was (2.7±0.9)g/L, significantly higher than [(2.0±0.5)g/L, P＜0.05] in the control; re-bleeding rates at 2 week, 1 month and 3 month were 0.0%, 0.0% and 2.2%, all much lower than 11.1%, 17.8% and 31.1%(P＜0.05) in the control group. Conclusion Endoscopic lauromacrogol sclerosis injection in combination with somatostatin in dealing with LC patients with EGVB could obtain rapid hemostasis, and maybe regulate gastrointestinal hormones balance, which warrants further clinical investigation.

Key words: Liver cirrhosis, Esophageal and gastric variceal bleeding, Endoscopic lauromacrogol sclerosis, Somatostatin, Therapy

周娟, 张婷, 杨凌鉴, 张甜甜. 聚桂醇硬化注射术联合生长抑素治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者疗效研究^*[J]. 实用肝脏病杂志, 2026, 29(3): 381-384.

Zhou Juan, Zhang Ting, Yang Lingjian, et al. Endoscopic lauromacrogol sclerosis injection with combination of intravenous pumping of somatostatin in treatment of patient with hepatitis B-induced liver cirrhosis and esophageal and gastric variceal bleeding[J]. Journal of Practical Hepatology, 2026, 29(3): 381-384.

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聚桂醇硬化注射术联合生长抑素治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者疗效研究^*

Endoscopic lauromacrogol sclerosis injection with combination of intravenous pumping of somatostatin in treatment of patient with hepatitis B-induced liver cirrhosis and esophageal and gastric variceal bleeding

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