食管静脉出血套扎联合生长抑素防止再出血的观察

目的观察食管静脉曲张破裂出血行食管静脉曲张套扎术（EVL）后联合使用生长抑素对预防近期再出血的有效性。方法总结2001年10月至2010年10月因静脉曲张破裂引起上消化道大出血的病例174例,予内镜套扎治疗后,将使用生长抑素治疗病例设为观察组（68例）,未使用生长抑素治疗病例设为对照组（106例）,比较两组近期再出血的发生率。结果 174例食管静脉曲张破裂出血患者经内镜下套扎治疗后,观察组近期再出血率为22.06%,高于对照组近期再出血率（7.55%）,两组比较差异有统计学意义（P〈0.01）。结论 EVL预防再出血疗效较好,EVL联合使用生长抑素对预防近期再出血无优势,且生长抑素增加患者的医疗费用,对轻症病例不推荐使用。

Prevention of esophageal variceal rebleeding after ligation by somatostatin

Objective To evaluate the efficacy of endoscopic variceal ligation （EVL） and EVL with somatostatin for the prevention of rehaemorrhagia.Methods 174 cases of massive hemorrhage in gastrointestinal tract with esophageal varices bleeding from October 2001 to October 2010 was analyzed.Patients receiving endoscopic ligation were divided into the treatment group（68 cases） and control group（106 cases）.Treatment group received EVL with somatostatin.The incidence rate of rehaemorrhagia was determined within 2 weeks of post-treatment.Results The incident rate of rehaemorrhagia in patients receiving EVL with somatostatin （22.06%） was higher than the EVL group（7.55%）,P0.01.Somatostatin alone could not prevent rehaemorrhagia（SPSS13.0 Statistics Package）.Conclusion EVL can be used to treat rehaemorrhagia.Somatostatin can effectively stop bleeding,but it is not effecive to prevent rehaemorrhagia.Somatostatin is expensive and it is not recommended for patients with mild disease condition.