胆宁片联合内镜下套扎术治疗非酒精性脂肪肝肝硬化食管静脉曲张的临床观察
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篇名: 胆宁片联合内镜下套扎术治疗非酒精性脂肪肝肝硬化食管静脉曲张的临床观察
TITLE:
摘要: 目的:观察胆宁片联合内镜下套扎术治疗非酒精性脂肪肝肝硬化食管静脉曲张的疗效和安全性。方法:选取2015年9月-2016年9月我院收治的非酒精性脂肪肝肝硬化食管静脉曲张患者70例,按简单随机抽样法分为对照组和观察组,各35例。两组患者均接受内镜下套扎术,对照组患者术后以250 μg/h的速度静脉泵注注射用生长抑素72 h,并口服泮托拉唑钠肠溶胶囊40 mg,qd;观察组患者术后在对照组治疗的基础上加服胆宁片1 g,tid。两组均连续用药4周。观察两组患者的套扎情况、临床疗效、治疗前后食管静脉曲张分级情况、再出血事件和不良反应发生情况。结果:两组患者均顺利完成套扎术,其套扎次数组间比较差异无统计学意义(P>0.05)。观察组患者的总有效率为91.43%,显著高于对照组的74.29%,差异有统计学意义(P<0.05)。治疗前,两组患者的食管静脉曲张分级情况比较,差异无统计学意义(P>0.05);治疗后1、3个月时,两组患者的食管静脉曲张分级情况均显著优于治疗前,且观察组显著优于对照组,差异均有统计学意义(P<0.05),但两组治疗后3个月时与治疗后1个月时比较差异均无统计学意义(P>0.05)。随访3个月内,观察组患者再出血事件总发生率为14.29%,显著低于对照组的40.00%,差异有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:胆宁片联合内镜下套扎术治疗非酒精性脂肪肝肝硬化食管静脉曲张的疗效显著,可显著减轻患者的静脉曲张程度,降低其再出血事件的发生率,且未增加不良反应的发生。
ABSTRACT: OBJECTIVE: To observe clinical efficacy and safety of Danning tablets combined with endoscopic ligation in the treatment of esophageal varices in patients with nonalcoholic fatty liver cirrhosis (NFLC). METHODS: A total of 70 NFLC patients with esophageal varices in our hospital during Sept. 2015-Sept. 2016 were divided into control group and observation group by simple random sampling method, with 35 cases in each group. Both groups received endoscopic ligation. Control group was given Somatostatin for injection with intravenous pump at the speed of 250 μg/h for 72 h after surgery, and Pantoprazole sodium enteric-coated capsules 40 mg, qd. Observation group was additionally given Danning tablets 1 g, tid, on the basis of control group. Both groups were given medicine for consecutive 4 weeks. The situation of ligation and clinical efficacies were observed in 2 groups, and the grading of esophageal varices before and after treatment, the occurrence of re-bleeding events and ADR were observed. RESULTS: The patients of 2 groups completed ligation successfully, there was no statistical significance in the times of ligation between 2 groups (P>0.05). Total response rate of observation group was 91.43%, which was significantly higher than 74.29% of control group, with statistical significance (P<0.05). Before treatment, there was no statistical significance in the grading of esophageal varices between 2 groups (P>0.05). One month and three months after treatment, the grading of esophageal varices in 2 groups were significantly better than before treatment, and observation group was significantly better than control group, with statistical significance (P<0.05). There was no statistical significance of 2 groups between 3 months after treatment and one month after treatment (P>0.05). Total incidence of re-bleeding events in observation group was 14.29% within 3-month follow-up, which was significantly lower than 40.00% of control group, with statistical significance (P<0.05). There was no statistical significance in the total incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: Danning tablets combined with endoscopic ligation show significant therapeutic efficacy for esophageal varices of NFLC, significantly mitigate the degree of esophageal varices and reduce the incidence of re-bleeding without increasing the occurrence of ADR.
期刊: 2018年第29卷第6期
作者: 徐安芬,夏洪芬,程霖,王忠琼
AUTHORS: XU Anfen,XIA Hongfen,CHENG Lin,WANG Zhongqiong
关键字: 胆宁片;内镜下套扎术;非酒精性脂肪肝肝硬化;食管静脉曲张;疗效;安全性
KEYWORDS: Danning tablets; Endoscopic ligation; Nonalco- holic fatty liver cirrhosis; Esophageal varices; Efficacy; Safety
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