Evaluation Of Esophageal Variceal Bleeding In Hepatic Cirrhosis Based On Ultrasound,PSVR,Laboratory Indexes And Endoscopy

Objective: To investigate the predictive value of ultrasound,platelet spleen volume ratio(PSVR),laboratory indexes and endoscopy for esophageal variceal bleeding(EVB)in hepatic cirrhosis,so as to provide reference for clinical prevention and treatment of EVB.Methods: Clinical data of 90 patients with esophageal varices in hepatic cirrhosis admitted to the Department of Gastroenterology,the First Affiliated Hospital of Guangxi Medical University from January 2018 to December 2019 were collected.Patients were divided into the bleeding group(n=39)and the non-bleeding group(n=51)according to whether EVB was combined at the time of admission.Through statistical methods,based on a total of 31 indexes such as ultrasound,PSVR,laboratory indexes and endoscopy to explore the risk factors of EVB,analyze the relationship between ultrasound,PSVR and endoscopy.Results:1.Single factor analysis show that the course of disease,the history of upper gastrointestinal bleeding,total bilirubin(TBIL),aspertate aminotransferase(AST),alanine aminotransferase(ALT),splenic venous flow,thickness of spleen,spleen diameter,spleen volume,Child-Pugh grading,esophageal varices diameter,red color sign,degree of esophageal varices and gastric varices 14 indicators are statistically significant differences between bleeding and non-bleeding group(P<0.05).Further multivariate logistic regression analysis of the 14 indicators with statistical significance in univariate analysis show that,the history of upper gastrointestinal bleeding and esophageal varices diameter are independent risk factors for EVB.2.Splenic vein diameter,thickness of spleen and spleen diameter in patients with severe esophageal varices were significantly larger than those in patients with mild esophageal varices(P < 0.05).PSVR in patients with severe esophageal varices were significantly smaller than those in patients with mild esophageal varices(P<0.05).PSVR of patients with red color sign or varicose gastric veins were smaller than that of patients without red color sign or varicose gastric veins,the difference was statistically significant(P<0.05).3.Among ultrasonic examination indexes,Splenic vein diameter(r=-0.718,P<0.001),thickness of spleen(r=-0.727,P<0.001)and spleen diameter(r=-0.750,P<0.001)are negatively correlated with PSVR.Conclusions:1.Splenic vein diameter,thickness of spleen and spleen diameter in patients with severe esophageal varices were significantly larger than those in patients with mild esophageal varices.PSVR in patients with severe esophageal varices were significantly smaller than those in patients with mild esophageal varices.PSVR of patients with red color sign or varicose gastric veins were smaller than that of patients without red color sign or varicose gastric veins.2.Splenic vein diameter,thickness of spleen and spleen diameter are highly negatively correlated with PSVR.3.The history of upper gastrointestinal bleeding and esophageal varices diameter are independent risk factors for EVB.