The Analyse Of Recent Curative Effect After Endoscopic Selective Varices Devascularization In Patients With Esophageal And Gastric Varices

Objective:This thesis is to investigate the recent effectiveness and safety of Endoscopic selective varices devascularization,ESVD in patients with Esophageal and gastric varices bleeding,EGVB caused by Liver cirrhosis.Methods: Step I.Search the cases from the case information management system in our hospital.These cases are patients with EGVB who have treated by Endoscopic selective varices devascularization,ESVD from October,2017 to October,2021.Finally 632 patients were included in this study.Step II.Collect the patients’ information includes 4 parts.Firstly,basic features(gender,age,ethnicity,vital signs).Secondly,Clinical features(main symptoms,causes of cirrhosis,preoperative laboratory tests,blood routine,liver function,coagulation function,portal vein CTA,Child-Pugh score,presence or absence of other diseases,presence of complications,postoperative complications).Thirdly,some conditions of endoscopic treatment.Lastly,something about other interventions.Step III.According to the endoscopic treatment mode of the patients,they were divided into three groups: the selective varices devascularization group,obturation + ligation group and obturation + sclerotherapy group,and analyze the baseline data and clinical outcomes of the three groups of patients with different treatment methods.Based on the treatment time and in order to comparing the hemostatic effect,the endoscopic selective varices devascularization group was divided into emergency treatment and non-emergency treatment group.Step V.Follow-up: Search the re-examination cases through the case system,and call up by telephone if there is no follow-up information.Results:.A total of 632 patients with EGVB were collected,including 567 males and 65 females.The minimum age is 37 years old,the maximum age is 73 years old,and the average age is 54 years old.According to the cause of cirrhosis: there were294 cases of hepatitis B,145 cases of hepatitis C,176 cases of alcohol,and 17 were other cases.According to the ethnicity: there were 285 cases of Zhuang nationality,157 cases of Han nationality and 190 cases of other ethnicities.Besides,there were 82 cases of Child-Pugh A grade,386 cases of Child-Pugh B grade,and 164 cases of Child-Pugh C grade,and there were 177 cases of oesophageal varices graded G1,216 cases of G2 grade,and 239 cases of G3 grade.The success rates of stopping bleeding,There was significant difference in the success rate of hemostasis between the two groups.Emergency treatment and non-emergency treatment group has good hemostatic effect in selective varices devascularization group,the success rate of emergency treatment of bleeding is significantly higher than not-emergency treatment group.After the treatment,the data of showed efficiency,non-efficiency in the three groups as the following: the selective varices devascularization group was 89.38%,10.61%.The obturation + ligation group was 76.75%,23.24%,and the obturation + sclerotherapy group was 74.19%,25.80%,and the total improvement rate of Esophageal and gastric varices bleeding,EGVB was statistically different among the three groups(P<0.05).The incidence of adverse reactions in selective varices devascularization group,tissue glue + ligation group and tissue glue+ sclerotherapy group were 30.03%,32.80% and 41.50%,respectively,and there was no statistical significance between the three groups(P<0.05).VI.After treatment,the rates of early rebleeding and delayed bleeding in the three groups were6.2% and 1.8% in inselective varices devascularization group,15.5% and 8.90% in tissue glue+ ligation group,and 11.3% and 8.5% in tissue glue + sclerotherapy group.There were significant differences in the rate of early rebleeding and delayed bleeding among the three groups(P<0.05,P<0.05).Conclusion:First,the study suggests that ESVD has a good therapeutic effect on Esophageal and gastric varices,EGVB.Next,the incidence and the rate of rebleeding of complications after ESVD treatment is lower than that of traditional gastric fundus tissue glue injection + esophageal variceal ligation and gastric fundus tissue glue injection + Esophageal varices sclerotic injection.Finally,The improvement rate of ESVD in the treatment of varicose veins was better than that of traditional gastric fundus tissue glue injection +esophageal variceal ligation and gastric fundus tissue glue injection + Esophageal varices sclerotic injection.