应用国产聚桂醇联合普萘洛尔治疗食管静脉曲张的回顾性研究
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应用国产聚桂醇联合普萘洛尔治疗食管静脉曲张的回顾性研究

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摘要:目的 回顾性评价应用国产聚桂醇治疗乙肝肝硬化食管静脉曲张效果。方法  急性食管静脉破裂出血或者胃镜下显示食管静脉重度曲张,预期近期有出血危险的晚期肝硬化患者,给予国产聚桂醇血管内注射,同时患者术前一周开始常规给予治疗剂量普萘洛尔口服并长期维持,分别于治疗后1个月、3个月、6个月、9个月进行胃镜复查,根据胃镜下静脉曲张消失情况评价疗效,并对并发症进行评估。结果 80例患者先后进行164次治疗,共有68例患者完成系统硬化并接受连续观察3-9个月,胃镜下复查结果显示静脉曲张完全消失24例,显效率为35%,静脉曲张转为轻度37例,转为中度7例,复诊全部患者原红色征均消失,治疗有效率100%。 接受治疗的所有患者中有10例出现治疗后短期的进食时胸骨后不适或者疼痛感觉,其中8例于治疗后一周消失,1例持续至治疗后2周逐渐消失;有1例患者于治疗后1个月出现食管狭窄的症状,未行特殊治疗于第3个月时复诊时症状消失。在所有164例次的硬化治疗中有16例次出现术后低热,发生率10.4%,全部病例均于1-2天发热消退。2例分别于治疗后5天和7天出现胸腔出血,经保守治疗后恢复。结论 胃镜下硬化治疗是乙肝肝硬化患者食管静脉曲张破裂出血的有效预防和治疗手段,国产乙氧硬化醇疗效可靠,安全性较好,能够满足临床需要。普萘洛尔口服联合胃镜下硬化治疗是治疗肝硬化食管静脉曲张行之有效的方法。
关键词:食管静脉曲张; 硬化治疗;国产聚桂醇注射液;普萘洛尔

Retrospective Study on the Treatment of Esophageal Varicosis with Homemade Lauromacrogol  and Propranolol in Liver Cirrhosis Patients
       Jia Kedong, Li Tao, Wu Fangyu, Rao Jianfeng, Li Yaya
Nanchang Liver Diseases Hospital (The Nanchang Ninth Municipal Hospital )

Abstract
   [Objective]  Retrospectively appreciate the value of homemade Lauromacrogol  with Propranolol in the treatment of Esophageal Varicosis.  [Methods] Cirrhosis patients with acute esophageal varicosis bleeding and severe esophageal varicosis evaluated by endoscopes were treated by homemade Lauromacrogol injection and propranolol per os. The degree of varix resolution  after sclerotherapy was evaluated by endoscopes at month 1th, 3th , 6th and 9th respectively. The complications of the therapy was also investigated simultaneously. [Results] Among 80 patients who conducted 164 sclerotherapies, 68 patients completed the series esophageal varies eradication plan and 3-9months follow up. There were 24/68(35%) patients show varix resolution completely, 37/68 patients became slight and 7/68 patients became midrange esophageal varicosis. All patients with sclerotherapy show red colour sign disappear after 3-9mongths follow up. For the complications of the sclerotherapy with homemade Lauromacrogol, 10 patients had slight discomfort or pain symptoms behind sternum temporarily.  Above symptoms were disappear after 1 week ( 8 patients) and 2 weeks (1 patients). Only one patients had symptom of stenosis of esophagus, but with amelioration at 3 months follow up without special treatment. Among 164 times sclerotherapy, 16 patients show slight fever (37.5℃~38.8℃ ) after sclerotherapy, but all recovery in 1 to 2 days. 2 patients showed bleeding in thoracic cavity after 5 days and 7 days respectively, both cured by the methods of thoracentesis and pharmacotherapy in two weeks.  [Result] Sclerotherapy combined with propranolol is an effective method for the prevention and treatment of esophageal variceal bleeding. The homemade Lauromacrogol is well enough to satisfy with the clinical need.
Keywords : Esophageal varicosis,  Sclerotherapy,  Homemade Lauromacrogol,  Propranolol


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