内镜下套扎联合奥曲肽和埃索美拉唑治疗肝硬化并发食管静脉曲张破裂出血患者临床疗效研究*

doi:10.3969/j.issn.1672-5069.2024.06.026

Abstract

Abstract: Objective The aim of this study was to investigate clinical efficacy of endoscopic variceal ligation (EVL) and intravinous octreotide and esomeprazole infusion in the treatment of patients with liver cirrhosis (LC)and esophagogastric variceal bleeding(EVB). Methods 99 patients with LC and EVB were admitted to our hospital between December 2020 and December 2022, and were randomly divided into observation (n=49) and control group (n=50). All patients received EVL and intrvinous esomeprazole infusion, and those in the observation were additionally given intravenous octreotide bumping for 7 days. Serum nitric oxide (NO), endothelin (ET) and angiotensinⅡ (ATⅡ) levels were assayed. Portal vein diameter (PVD), portal vein flow (PVF), splenic vein diameter (SVD) and splenic vein flow (SVF) were detected by ultrasonography. Results Two and two patients didn’t survive emergent bleeding in both groups; of survivals, hemostasis rates at 24 h, 48 h and 72 h in the observation group were 66.0%, 95.7%and 100.0%, not significantly different compared to 62.5%, 85.4%and 100.0%(P＞0.05)in the control; after treatment, PVD, PVF and SVF in the observation were(10.5±1.6)mm,(252.4±42.6)mL/min and(526.3±68.9)mL/min, all significantly lower than [(12.1±1.4)mm, (304.5±41.6)mL/minand (611.4±64.5)mL/min, respectively, P＜0.05] in the control; serum NO level in the observation was (73.2±7.6) mol/L, much higher than [(64.9±7.4) mol/L, P＜0.05], while serum ET and ATⅡ levels were (90.2±9.3)ng/L and (3.0±0.5)pg/mL, much lower than [(104.8±11.4)ng/L and (4.1±0.6)pg/mL, P＜0.05] in the control group; one year of follow-up after treatment, re-bleeding rates in the observation and control groups were not much statistically significantly different (10.6%vs. 12.5%,P＞0.05). Conclusion EVL and octreotide and esomeprazole combination in dealing urgently with patients with EVB has a satisfactory hemostasis efficacy, which might improve liver hemodynamicsand serum vascular activity.

Key words: Liver cirrhosis, Esophagogastric variceal bleeding, Endoscopic variceal ligation, Octreotide, Esomeprazole, Therapy, Re-bleeding

Ma Li, Gu Zhongsheng, Li Xiang. Clinical efficacy of endoscopic variceal ligation and intravinous octreotide and esomeprazole infusion in the treatment of patients with liver cirrhosis and esophagogastric variceal bleeding[J]. Journal of Practical Hepatology, 2024, 27(6): 903-906.

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Clinical efficacy of endoscopic variceal ligation and intravinous octreotide and esomeprazole infusion in the treatment of patients with liver cirrhosis and esophagogastric variceal bleeding

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