【摘要】 目的探讨凝血酶纤维蛋白聚硅醇序贯法治疗胃底静脉曲张破裂出血的临床价值。方法 120例胃底静脉曲张破裂出血患者,采用随机数字表法分为治疗组和对照组各60例,治疗组采用凝血酶、纤维蛋白原、聚硅醇序贯硬化栓塞法,对照组采用组织胶、聚硅醇序贯栓塞硬化法。观察两组止血成功率、仪器损害、再出血率、静脉改善、并发症等指标。结果两组止血成功率差异无统计学意义(P>0.05),术后再出血率治疗组高于对照组(P<0.01)。治疗后1个月两组患者胃镜复查胃底静脉曲张程度及发热、上腹痛发生率差异均无统计学意义(P>0.05),治疗组堵针、粘镜发生率及操作时间均明显低于对照组(P<0.05)。两组均未出现异位栓塞等严重并发症。结论凝血酶纤维蛋白原聚硅醇序贯法治疗胃底静脉曲张破裂出血安全有效。更多还原

【Abstract】 Objective To explore the therapeutic value of lauromacrogol injection with fibrinogen and thrombin in the treatment of gastric fundus varices hemorrhage.Methods One hundred and twenty patients with gastric fundus varices bleeding were randomly divided into therapeutic or control groups,60 in each group.The therapeutic group was treated with a sequentially lauromacrogol injection with fibrinogen and thrombin.The control group was treated with lauromacrogol injection with tissue adhesive.The success rate of hemostasis,instrument damage,rebleeding rate,venous improvement and complications were compared between the two groups. Results There was no significant difference in the success rate of hemostasis between the two groups( P > 0. 05).The postoperative rebleeding rate in the therapeutic group was higher than that in the control group( P < 0. 01).There was no statistical difference in gastric variceal degree reviewed by gastroscope and in incidence of fever and upper abdominal pain between the two groups( P > 0. 05).However,the incidence of needle blocking and endoscopic adhesive as well as operation time in the therapeutic group were lower or shorter than that in the control group( P < 0. 05).No ectopic embolism or perforation was observed in the two groups.Conclusion The use of fibrinogen and thrombin in the treatment of gastric fundus varices hemorrhage is safe and reliable.更多还原