Analysis Therapeutic Effect And Complications Of Esophageal Varices Bleeding Under Endoscope With Hardener

Objective1.To observe the impact of esophageal variceal bleeding by gastroscopyhemoclipping treatment and the therapeutic effects were compared drugs.2.To comparethe observed endoscopic injection sclerotherapy aethoxysklerol (Germany) andlauromacrogol (domestic) treatment of esophageal variceal hemorrhage andcomplications.3.To analysis the effect of ages on bleeding after hardener recurrenttreatment.4.To analysis the effect of different Child-pugh on bleeding after hardenerrecurrent treatment.Methods300patients with cirrhosis of the liver and EVB were analyzedretrospectively in Shannxi provincial People’s Hospital from2010.1.1to2013.4.30.122cases who received endoscopic esophageal varicose vein hardener injection therapy(a total of227times) and178cases took medication.To compare the curative effect between drugtreatment and hardener injection therapy during the next3-12months.122patients weresplit into two groups on the basis of different types of curing agent:group A59patientsgive aethoxysklerol (Germany) and group B63petients give lauromacrogol (domestic).According to ages and grade of the Child-pugh,respectively,group A and B into different subgroups respectively. By active preoperative preparation, emergency or suspend thebleeding within24-48hours for gastroscopy，then Group A receive alcohol ethoxysclerosis injection treatment and Group B Were given poly cinnamyl alcohol injectiontreatment.Two groups have in common is that all patients were adopted the loweresophagus dentate line edge equinoctial within1-2cm of varicose vein injection.The twogroup patients were fasted temporally24hours after the operation, told the patient to stayin bed, and avoided sudden exertion.we should observe sufferer vital signs (respiration, heart rate, blood pressure) and defecate color, bowel sounds, etc.At the same time Thetwo group patients were given antibiotics2-3days to prevent infection.To observe agesand different Child-pugh on bleeding after hardener recurrent treatment; Focus on therecurrence of bleeding after different treatments and the bleeding rate of72hours aftertreatmentand the incidence of complications,such as fever, chest discomfort, ectopicthrombosis, the puncture point after ulcer and esophageal erosion.Result1.The treatment of hepatocirrhosis with EVB:compared with drug therapygroup, hardener injection therapy for72hours hemostatic rate increased significantly andthere is statistically significant（P <0.05）2.72hours hemostatic rate:In group A,118cases were stopped bleeding successfullyhemostatic rate is98.3%and in the group B,106cases were stopped bleeding successfully hemostatic rate is99.1%.There is no statistical significance between two groups（P>0.05）.3.complications: bycontrast group A(0.8%),group B(7.5%) has higher heating rateand there has statistically significant between two group（P <0.05）.For theheat, all below39℃a ndthe body temperature can drop to normal after given anti-infection.Other complications(Chest discomfort, heterotopic thrombosis, the puncture point ulcer, esophageal erosion) have no statistical significance between two groups（P>0.05）4.Curing agent treatment of esophageal varices bleeding:the elderly patients has higher recurrence rate of bleeding than youth group and there is statistically significant（P <0.05）.5.Patients who in the different liver function Child-pugh grade group, whoseChild-pugh classification worse, worse liver function,and the recurrent hemorrhage rateof endoscopic sclerotherapy is higher, there w as significant difference (P <0.05).Conclusion1.The treatment effects of hysteromyoma to hepatocirrhosis with EVB isacceptable and better than the medication.2.Aethoxysklerol and lauromacrogol not only have a similar effect bur also theincidence of complications are low and have high-security. 3.The age is higher, hemorrhage rate is higher and the curative effect is poorer afterthe hardener treatment and the consideration is patients’ age, basic disease leading the body repair ability poorly.4.The Child-pughB, class C hardener curative effect is worse after treatment compared with a Child-pughA.The consideration is liver function in patients of B and C level is poor and more complications and the environmental disturbance lading the basis of thebody repair ability poorly.From the above，esophageal variciform sclerotherapy isbetter than the medication,therecurrence of bleeding rate is proportional to ages and the Liver function classification,therefore, patient who has the smaller age and the better grade of liver function will have bettercurative effect.