摘要
目的:探讨采用三腔二囊管3 种固定方法在食管胃底静脉曲张破裂出血患者压迫止血中的应用疗效.方法:选取2021 年1 月至2022 年10 月我院收治的食管胃底静脉曲张破裂出血患者 210例为研究对象,采用抽签法将患者完全随机分为传统固定组、鼻塞固定组、乒乓球固定组各 70 例,其中传统组采用传统法固定三腔二囊管,鼻塞固定组采用鼻塞法固定,乒乓球固定组采用乒乓球法固定.比较三组患者临床疗效(止血有效率、出血控制时间、输血量、再出血率)、并发症发生率(鼻黏膜破损、室息、胸闷、胸骨后疼痛、咽喉部损伤)及气囊破损率、置管成功率差异,记录治疗前及治疗后 6 个月时出血相关生化指标(血红蛋白、尿素氮、血小板数量)、凝血功能指标(纤维蛋白原含量、凝血酶原时间、凝血活酶时间)差异.结果:止血有效率、置管成功率组间比较结果均为乒乓球固定组(97.44%、100%)>鼻塞固定组(94.87%、97.14%)>传统固定组(87.50%、78.57%),且差异均具有统计学意义(P<0.05);三组患者临床疗效指标(出血控制时间、输血量)依次为乒乓球固定组<鼻塞固定组<传统固定组,且组间比较差异均具有统计学意义(P<0.05);与治疗前相比,三组患者治疗后6 个月血红蛋白含量、血小板数量均明显升高(P<0.05),且升高幅度依次为乒乓球固定组>鼻塞固定组>传统固定组;尿素氮浓度明显降低(P<0.05),且降低幅度依次为乒乓球固定组>鼻塞固定组>传统固定组;三组患者再出血率、气囊破损率、凝血功能指标均无显著差异(P>0.05).结论:与鼻塞固定法及传统固定法相比,乒乓球固定三腔二囊管有效提高临床止血疗效,能够最大程度减少并发症的发生概率,且具有较高成功率.
Abstract
Objective:To explore the application efficacy of three fixation methods of Sengstaken-Blake-more tube on compression hemostasis in patients with esophageal and gastric varices bleeding.Methods:A to-tal of 210 patients with esophageal and gastric varices bleeding admitted to our hospital from January 2021 to October 2022 were selected as the study subjects.The patients were randomly divided into traditional fixation group,rhinobyon fixation group and table tennis fixation group by means of the randomization method,with 70 cases in each group.The traditional fixation group was fixed with Sengstaken-Blakemore tube by traditional method,and the rhinobyon fixation group was fixed by rhinobyon method,and the table tennis fixation group was fixed by table tennis method.The clinical efficacy(hemostasis effective rate,bleeding control time,blood transfusion volume,rebleeding rate),incidence rates of complications(nasal mucosa damage,asphyxia,chest tightness,retrosternal pain,throat injury),airbag breakage rate and catheterization success rate were compared among the three groups of patients.The differences in bleeding-related biochemical indicators(he-moglobin,urea nitrogen,platelet count)and coagulation function indicators(fibrinogen content,prothrombin time,thromboplastin time)were recorded before treatment and at 6 months after treatment.Results:The he-mostasis effective rate and success rate of catheterization were shown as table tennis fixation group(97.44%,100%)>rhinobyon fixation group(94.87%,97.14%)>traditional fixation group(87.50%,78.57%)(P<0.05).The clinical efficacy indexes(bleeding control time,blood transfusion volume)were manifested as ta-ble tennis fixation group<thromboplastin fixation group<traditional fixation group(P<0.05).Compared with before treatment,the hemoglobin content and platelet count in the three groups were significantly increased at 6 months after treatment(P<0.05),and the increases revealed table tennis fixation group>thromboplastin fix-ation group>traditional fixation group.The concentration of urea nitrogen was significantly decreased(P<0.05),and the decrease was expressed as table tennis fixation group>thromboplastin fixation group>traditional fixation group.There were no obvious differences in rebleeding rate,airbag breakage rate and coagulation function indicators among the three groups(P>0.05).Conclusion:Compared with rhinobyon fixation method and traditional fixation method,table tennis fixation method with Sengstaken-Blakemore tube can more effec-tively improve the clinical hemostatic efficacy and reduce the probability of complications to the greatest ex-tent,and it has a higher success rate.
基金项目
陕西省自然科学基础研究计划(2018JQ8047)
维普
万方数据