内镜下套扎术后应用卡维地洛治疗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.1672-5069.2021.03.025

Abstract

Abstract: Objective The aim of this study was to observe the efficacy of endoscopic variceal ligation (EVL) and carvedilol maintenance in the treatment of patients with liver cirrhosis and complicated esophagogastric variceal bleeding (EVB). Methods A total of 72 patients with liver cirrhosis and EVB were enrolled in our hospital between December 2017 and December 2019, and were randomly divided into control (n=35) , receiving EVL, and observation group (n=37), receiving carvedilol maintenance after EVL. All patients were followed-up for 12 months. Serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by ELISA.Results Two and four patients in the observation and control group respectively in our series died from emergent bleeding (P>0.05); there were no significant differences in the blood transfusion volume and hemostasis time between the two groups (P>0.05), but the hospital stay in observation group was significantly shorter than that in control group [(10.4±2.4)d vs.(12.1±2.2)d, P<0.05]; there were no significant differences as respect to blood routine and liver function tests at presentation and 2 weeks after treatment between the two groups (P>0.05); at admission, there were no significant differences with respect to serum CRP, IL-6 and TNF-α levels between the two groups (P>0.05), while 2 weeks after the treatment, serum CRP, IL-6 and TNF-α levels in the observation group were (4.9±0.32)mg/l, (20.4±9.4)pg/ml and (25.1±8.1)pg/ml, significantly lower than [(6.3±5.5)mg/l, (28.6±7.6)pg/ml and (34.7±9.3)pg/ml, respectively, P<0.05] in the control; there were no significant differences in the incidence of adverse reactions between the two groups (42.9% vs. 48.4%, P>0.05); at the end of 3 months and 6 months of follow-up, the re-bleeding rates were 11.4% and 20.0% in observation group, significantly lower than 29.0% and 45.2% in the control group (P<0.05).Conclusion The carvedilol maintenance after EVL has a good efficacy in the treatment of patients with liver cirrhosis and EVB, which is worthy of further clinical investigation.

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

Wu Chang, Zhang Yuan’an, Peng Chunfen. Efficacy of endoscopic variceal ligation and carvedilol maintenance in the treatment of patients with liver cirrhosis and esophagogastric variceal bleeding[J]. Journal of Practical Hepatology, 2021, 24(3): 403-406.

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Efficacy of endoscopic variceal ligation and carvedilol maintenance in the treatment of patients with liver cirrhosis and esophagogastric variceal bleeding

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