Comparison Of EVL And TIPS In The Prevention Of Moderate To Severe Esophageal Varices Bleeding

Objective:To evaluate the EVL and TIPS cirrhosis esophageal varices bleeding effect of secondary prevention.Methods:A hospital gastroenterology, two wards in January 2009-June 2014 to meet the requirements of the data of 100 patients, of which EVL45 cases, TIPS 55 cases. Two groups of patients before general information (age, gender, etiology, child-pugh classification of liver function, varicose veins indexing) were analyzed; 18-month follow-up after treatment compared with EVL TIPS efficacy (early rebleeding rate, late rebleeding, mortality, outcome varicose veins) and bleeding intervals again, the average number of hospitalizations per capita total cost of hospitalization. Application SPSS 17.0 statistical package for relevant indicators into the statistical analysis. Results:1、patients were age, gender, etiology, liver function classification, indexing varicose veins and other general differences were not statistically significant (Table 1-5), two sets of data were comparable.2、EVL group and TIPS group early rebleeding rate compared to (35.6% vs 3.6%, P <0.01) difference was statistically significant, compared to late rebleeding rate:6 months after surgery (28.9% vs9.0%,< 0.01), in December (37.8% vs12.7%, P= <0.01),18 months (48.9% vs18%,<0.01) difference was statistically significant; mortality compared to (11.1% vs7.3%, P= 0.51) difference was not statistically significant.3、EVL group, TIPS group followed up the end of the patient varicose vein from the efficiency (87.5% vs 90%, P= 0.683), markedly effective rate (55% vs 62.7%, P= 0.455), efficiency (32.5% vs 27.5%, P= 0.601), compared to no difference between efficiency (5% vs 9.8%, P= 0.393) and other groups was not statistically significant, EVL after 3 cases of varicose veins worse compared with TIPS (7.5% vs 0%, P= 0.047) difference was statistically significant.4、 EVL treatment groups:18 patients hospitalized for bleeding again repeated, again after initial treatment of bleeding from an average of 98.27 days, the average number of hospitalizations as follows:2.73 times, the total cost of hospitalization per capita: 69,289.4 yuan.TIPS treatment groups:four patients hospitalized again because of postoperative bleeding, bleeding again after initial treatment from an average of 230.19 days days, the average number of hospitalizations as follows:1.06 times, the total cost of hospitalization per capita:65,216.2 yuan.Conclusion:1、EVL and TIPS can effectively prevent bleeding in patients with cirrhosis EVB again, then TIPS compared with EVL significantly lower bleeding rates both preventive measures compared to no effect on mortality.2、 two prevention programs no significant difference from the long-term efficiency of varicose veins, EVL may increase the presence of varicose veins.3、 EVL treatment group re-bleeding from the initial treatment time than TIPS treatment group was significantly shorterEVL treatment group, the average number of hospitalizations than the TIPS group increased,compared with the total cost of hospitalization per treatment group TIPS high.