杨少宾 张朝平 张丽

摘 要 目的：探讨内镜下套扎联合普萘洛尔治疗肝硬化上消化道出血的疗效。方法：选取 96例肝硬化上消化道出血患者，采用隨机数表法分为观察组和对照组各48例，对照组采用静脉全身麻醉后内镜下套扎，观察组在对照组的基础上给予普萘洛尔口服。比较两组患者的止血、住院时间，门静脉和脾静脉的血流量，1年内再次出血率和不良反应发生率。结果：观察组的止血和住院时间短于对照组；门静脉和脾静脉的血流量少于对照组；1年内再次出血率低于对照组（P<0.05），两组不良反应发生率差异无统计学意义（P>0.05）。结论：内镜下套扎联合普萘洛尔治疗肝硬化上消化道出血，可有效缩短患者的止血、住院时间，减少门静脉和脾静脉的血流量，降低患者1年内再次出血率。

关键词 肝硬化 上消化道出血 内镜下套扎 普萘洛尔

中图分类号：R972； R657.34 文献标志码：B 文章编号：1006-1533（2021）11-0033-03

Efficacy of endoscopic band ligation combined with propranolol in the treatment of upper gastrointestinal bleeding in liver cirrhosis

YANG Shaobin1*， ZHANG Chaoping2， ZHANG Li1

（1. Department of Gastroenterology； 2. Department of Nephrology， Sanmenxia Hospital of the Yellow River， Henan Sanmenxia 472000， China）

ABSTRACT Objective： To study the clinical effect of endoscopic band ligation combined with propranolol in the treatment of upper gastrointestinal bleeding. Methods： Ninety-six cases of variceal upper gastrointestinal hemorrhage were selected and divided into an observation group and a control group with 48 cases each by random number sampling method. The control group underwent endoscopic band ligation after intravenous general anesthesia and the observation group took oral propranolol additionally on the basis of the control group. The times for hemostasis and hospitalization， the blood flow volumes of the portal vein and splenic vein， the rebleeding rate within one year of follow-up and the incidence of adverse reactions were compared between the two groups. Results： The times for hemostasis and hospitalization were shorter， the blood flow volumes were less and the rebleeding rates within one year of follow-up were lower in the observation group than the control group （P<0.05）. There was no statistical significance between the two groups in the incidence of adverse reactions （P>0.05）. Conclusion： Endoscopic band ligation combined with oral propranolol can effectively improve the therapeutic effects of acute variceal upper gastrointestinal bleeding caused by liver cirrhosis and reduce the rebleeding rate of patients within the one year of following-up.

KEy WORDS cirrhosis； upper gastrointestinal bleeding； endoscopic band ligation； propranolol

肝硬化上消化道出血，是由于门静脉和其支血管的压力较大而导致的[1]。若患者的出血情况比较严重的话，极有可能引发大出血，在治疗上就较为麻烦和困难[2]。内镜下套扎术具有快速止血的特点，目前被广泛应用于该病的治疗上，普萘洛尔也对消化道的出血有良好的止血效果[3]。

1 资料与方法

1.1 一般资料

选取河南省黄河三门峡医院2018年4月—2019年5月收治的96例肝硬化上消化道出血患者，采用随机数表法分为观察组和对照组各48例。其中观察组男28例，女20例；年龄28～70岁，平均年龄（45.81±2.81）岁。对照组男30例，女18例；年龄29～71岁，平均年龄（45.52±2.51）岁。两组患者一般资料比较差异无统计学意义（P>0.05），具可比性。