The Comparison Of Two Treatments Of Upper Gastrointestinal Bleeding Of Esophagogastric Variceal Hemorrhage In Hepatic Cirrhosis

Objective To investigate the effects of endoscopic variceal ligation and pericardial devascularization ( splenectomy with periesophagogastric devascularization)in the treatment of esophagogastric variceal bleeding (EGVB). So we can choose more effective treatment. In order to improve clinical diagnosis and treatment.Methods 60 patients with hepatic cirrhosis complicated by EGVB were come from The 1st hospital of JiLin University. It divided into two groups, In this study,30 cases suffered from esophagogastric variceal bleeding were assigned to receive endoscopic variceal ligation alone, and the other 30 cases were assigned to receive devascularization alone.Compare changes in liver function of the two groups preoperative and postoperative at 6 months. Compare white blood cell and platelet of preoperative and postoperative 1 week. Compare the rate of hemostasis after after surgery 1month,6 months,1 year.between endoscopic variceal ligation group and devascularization group.Compare complication rate of the two groups. Statistic analysis: Count data were denoted by the number of cases or percentage,measurement data were denoted by average±standard deviation (x±s), Count data among two groups used Chi-aquare (X2)test, measurement data usined t test.All of the data were analyzed by SPSS12.0 software. P<0.05 showed that variation was significant.Results There was no significant difference in the endoscopic variceal ligation group of albumin, total bilirubin, alanine aminotransferase of postoperative and preoperative(P> 0.05), It has no significant changes in liver function. There was significant difference in the devascularization group of albumin of postoperative and preoperative(P<0.01)and with significant deterioration of liver function. There was significant difference in the devascularization group of white blood cell and platelet of postoperative and preoperative(P<0.05). There was no significant difference in the endoscopic variceal ligation group of white blood cell and platelet of postoperative and preoperative(P>0.05). there was significant difference in the rate of rebleeding (one month) between devascularization and endoscopic variceal ligation(P<0.05)There was no significant difference in the rate of rebleeding (6 months, 1 year )between the two groups(P>0.05).the incidence of complications in devascularization group was 50%, portal vein thrombosis and incision pain each make up 33%, the incidence of complications in endoscopic variceal ligation group was 30%. There was significant difference in complication rate between the two groups. The complication rate of devascularization group is higher than the endoscopic variceal ligation group, and the type of complications in devascularization group is more than ligation group. ConclusionCompared to endoscopic variceal ligation and devascularization group,hepatic function of endoscopic variceal ligation group therapy has no obvious changes to some different degree in the patients. The devascularization group was with significant deterioration of liver function. Compared the two groups. The complications of endoscopic variceal ligation group is much lesser. Endoscopic variceal ligation therapy was superior to devascularization in clinical recovery. For esophagogastric variceal in hepatic cirrhosis with hypersplenism or splenomegal,devascularization is feasible.