Clinical Value Of Combine Sclerotheropy With Endoscopic Injection Of Tissue Adhesive For Critical Active Esophagogastric Variceal Bleeding

Objective : To investigate the effects of sclerotherapy,endoscopic injection of tissue adhesive alone and combine them in the treatment of critical esophagogastric variceal bleeding(EGVB).Methods : In this study,115 cases suffered from lethal active esophagogastric variceal bleeding were randomly assigned to receive emergent endoscopic variceal sclerotherapy alone (group A,65 cases), injection of tissue adhesive alone (group B,24 cases) and combine sclerotherapy with injection of tissue adhesive (group C,26 cases).All procedures were carried out under the modified S-B tube compression in 67 cases.Results:In the following-up(12 months)period,the recent effective hemostatic rates were 81.5%,95.8% and 100% in the three groups respectively. The rates of fever were 73.8%,87.5% and 76.9% . And the rate of chest pain were 84.6%,70.8% and 76.9% respectively.The early relapsed bleeding (<6 months)rates were 16.1%,50.0% and 10%.The late relapsed bleeding (>6 months)rates were 29.0%,62.5% and 25.0%.The eradicative rates were 64.5%,31.3% and 90% respectively in the three groups.Conclusion: Combined sclerotherapy with endoscopic injection of tissue adhesive under the modified S-B tube compression is more effective and safer for EGVB in controlling active bleeding,eradicative rate and rebleeding rate. Tissue adhesive injection is more fit for gastric fondus variceal bleeding.