硬化剂注射联合药物治疗食管静脉曲张破裂出血疗效的研究

目的观察肝硬化食管静脉曲张患者硬化剂注射联合口服卡维地洛与单纯硬化剂注射后的再出血发生率、死亡率和治疗前后食管静脉曲张程度以及肝功能的分级变化。方法入选有效随访患者159例,其中82例患者采用硬化剂注射联合口服卡维地洛治疗,77例患者采用硬化剂注射治疗,两组患者给予多次注射硬化剂,直至曲张静脉消失,联合组同时给予卡维地洛,起始剂量为6.25 mg,每日2次,逐渐增加剂量至最大耐受量12.5 mg,每日2次。全部患者观察12月,对比两组间的出血在发生率和死亡率,治疗前后静脉曲张程度以及肝功能分级变化。结果联合治疗组82例,期间发生出血9例（10.9%,6月内）、16（19.5%,6月后）,死亡3例（3.7%）,硬化治疗组77例,期间发生出血13例（16.9%,6月内）、22（28.6%,6月后）,死亡8例（10.4%）。组间出血发生率（近、远期）和死亡率差异有统计学意义（P〈0.05）。两组治疗前后肝功能Child-Pugh评分比较差异无统计学意义（P〉0.05）。结论与单纯硬化剂注射治疗组相比,联合治疗组治疗可以降低出血率、死亡率和静脉曲张程度,同时患者肝功能无明显损害。

Efficacy of EIS combined with carvedilol on esophageal variceal bleeding

Aim To investigate the esophageal variceal bleeding,mortality,degree of varices and changes of liver function in patients with hepatic cirrhosis who underwent EIS combined with carvedilol or received EIS therapy.Methods One hundred and fifty-nine patients received either EIS combined with carvedilol(group 1,n = 82) or EIS therapy(group 2,n = 77).All the patients in two groups were treated with EIS for several times until varicose vein disappeared.Meanwhile,patients in group one received 6.25mg dose of carve...