Risk Factor Analysis Of Pleural Effusion Associated With The First Time Elective Endoscopic Injection Sclerotherapy

Objective:Discussed the risk factors of pleural effusion associated with the first time elective endoscopic injection sclerotherapy(EIS)for patients with esophageal varices.Methods:In this retrospective study,patients with esophageal varices associating hepatic cirrhosis underwent the first time elective EIS and all data were referred to The First Affiliated Hospital of Guangxi Medical University between December 2013 and December 2016.Single factor and multivariate analysis were conducted to evaluate the independent risk factors of pleural effusion associated with the first time elective EVS.Results: there were 119 patients who received the first time EIS during this period.Excluding 46 patients,in whom 14 with emergency operation,14 with pulmonary infection,4 with pleural effusion before EIS,2 with recent hemorrhage,2 with cardiac insufficiency,2 with hepatocellular carcinoma,2 combination of EVL,6 with incomplete data.A total of 73 patients were recruited to the study,65 were male and 8 were female,Average age was 52.35 years.Pleural effusion after the first timeelective EIS occurred in 21 patients(28.76%),20 patients were cured after treatment and 1 patient died.Univariate analysis revealed that varicose vein diameter(?~2=10.77,P=0.008),Child-Pugh Grade(?~2=7.70,P=0.019),amount of ascites(?~2=13.07,P=0.001),serum albumin[P=0.000,95%CI(-9.30~-4.28)],prothrombin time[P=0.038,95%CI(0.08~2.98)],post-EIS white blood cell count[P=0.005,95%CI(1.26~6.22)] and amount of sclerosant [P=0.013,95%CI(1.21~9.73)]were risk factors for pleural effusion after the first time elective EIS.Multivariate analysis indicated that amount of ascites [B=1.551,OR=5.61,95%CI(1.30~24.13),P=0.031],serum albumin [B=-0.230,OR=0.69,95%CI(0.54~0.87),P=0.011],Post EIS white blood cell count[B=1.877,OR=1.333,95%CI(1.01~1.76),P=0.044] were independent risk factors.Conclusion:1.incidence of pleural effusion was 28.8% in patients who underwent the first time elective EIS treatments.2.pleural effusion of post EIS associated with varicose vein diameter,Child-pugh Grade,prothrombin time,amount of sclerosant.3.The amount of ascites and volume of sclerosant volume were positive correlation with the risks of pleural effusion associated with the first time elective EIS,but Post EIS serum albumin was negative correlation with the first time elective EIS.