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目的 :观察奥曲肽或垂体后叶素、一次硬化剂注射、心得安序贯治疗食管静脉曲张出血的近期及远期疗效。方法 :1 38例病人分为三组。三组病人均先静脉使用奥曲肽或垂体后叶素 ,之后分别接受单纯心得安治疗 (心得安组 )、一次硬化剂注射治疗后继以心得安治疗 (硬化剂 +心得安组 )、多次硬化剂注射治疗 (硬化剂组 )。比较三组病人的平均止血时间、近期再出血率、远期再出血率、平均住院日数及并发症发生情况。结果 :硬化剂 +心得安组、硬化剂组的平均止血时间分别为 1 5 .1± 1 .9h ,1 4 .8± 1 .9h ,比心得安组的 1 9.9± 4 .6h短(均P <0 .0 1 )。但硬化剂 +心得安组与硬化剂组间比较无差异。近期再出血率硬化剂组较心得安组低 (P <0 .0 5) ,硬化剂 +心得安组与硬化剂组间比较及心得安组与硬化剂 +心得安组间比较无差异。远期再出血率硬化剂 +心得安组及硬化剂组均较心得安组低 (P分别为 <0 .0 5 ,<0 .0 1 ) ,硬化剂 +心得安组与硬化剂组间比较无差异。平均住院日数则硬化剂组较其余两组长 (均P <0 .0 1 ) ,而硬化剂 +心得安组与心得安组间比较无差异。结论 :奥曲肽或垂体后叶素、一次硬化剂注射、心得安序贯治疗食管静脉曲张出血的疗效与多次硬化剂注射治疗相似 ,是较好的治疗食管静脉曲张出血及预防再出?
Objective: To observe the short-term and long-term efficacy of octreotide or vasopressin, a sclerotherapy injection and propranolol for the treatment of esophageal variceal bleeding. Methods: One hundred and thirty-eight patients were divided into three groups. The patients in the three groups received intravenous octreotide or vasopressin intravenously before receiving propranolol (propranolol), a sclerotherapy injection followed by propranolol (sclerotherapy + propranolol), multiple sclerosants Injection therapy (sclerotherapy group). The mean hemostasis time, recent rebleeding rate, long-term rebleeding rate, average length of stay and complication were compared between the three groups. Results: The hardener + propranolol group, the hardener group, the average hemostasis time were 15.1 ± 1. 9h, 14.8 ± 1 .9h, compared with the safety group of 19.9 ± 4.6h (both P <0 .0 1). However, there is no difference between the hardener + the experience group and the hardener group. The rate of recent rebleeding in the sclerotherapy group was lower than that in the sclerotherapy group (P <0. 05). There was no difference between the sclerotherapy and prophylaxis group and the sclerotherapy group and the combination of the prophylaxis group and the sclerotherapy and propranolol group. The rate of long-term rebleeding of sclerosant + propranolol and sclerostin were lower than those of spironolactone (P <0.05, <0.01), and sclerostin + propranolol and sclerosant No difference. The average length of stay in the hardener group was longer than that in the other two groups (all P <0.01), while there was no difference between the hardener + propranolol group and propranolol group. Conclusions: Octreotide or pituitrin, a sclerotherapy, propranolol treatment of esophageal variceal bleeding and multiple sclerotherapy efficacy is similar, is a better treatment of esophageal variceal bleeding and prevention of reappearance?