Study On The Timing Of Emergency Endoscopy For Patients With High-risk Esophageal And Gastric Variceal Bleeding:A Cohort Study

Objective:To explore the clinical value of emergency endoscopy at different times in high-risk acute esophageal and gastric variceal bleeding in patients with liver cirrhosis,and to seek the best time.Methods:The retrospective research analyzed 71 high-risk Esophageal Variceal Bleeding in patients with Liver Cirrhosis treated in Nanchong Central Hospital from January 2019 to October 2021.They were divided into ultra-early group(≤12h,n=41)and early group(12h～24h,n=30)according to the timing of endoscopy after admission;The average length of hospital stay,volume of blood transfusion(red blood cell),bleeding characteristics,detection of bleeding site,hemostasis success rate in acute stage,early rebleeding rate and 6-week mortality were compared between two groups.Results:1.The detection rate of bleeding site in ultra-early group was significantly higher than that in early group(82.9%vs.53.3%,P<0.05);2.The hemostasis success rate in the ultra-early group was significantly higher than that in the early group(87.8%vs.60.0%,P<0.05);The early rebleeding rate in the ultra-early group was lower than that in the early group(14.6%vs.36.7%,P<0.05);3.There was no significant difference in 6-week mortality between the two groups(12.2%vs.16.7%,P>0.05).4.There was no significant difference in the average length of hospital stay and volume of blood transfusion between the two groups(P>0.05).Conclusion:1.The ultra-early emergency endoscopic intervention in high-risk patients with EGVB is better than the early group in detecting the bleeding site,improving the hemostasis success rate in the acute stage and reducing the rate of early rebleeding.2.The ultra-early emergency endoscopy intervention can not reduce the length of hospital stay and volume of blood transfusion,and can not improve the 6-week mortality of patients.