Risk Factors Of Early Rebleeding After Esophageal Variceal Ligation Of Single Center

OBJECTIVE: To investigate the hazard factors of early rehaemorrhagia after variceal ligation for esophageal variceal hemorrhage in patients with liver cirrhosis,can provide a theoretical foundation to prevent esophageal variceal hemorrhage after variceal ligation.METHODS: The clinical data of patients with cirrhosis from January 1,2012 to December 30,2017 were collected from our hospital,according to whether rebleeding occurred within 6 weeks after surgery owing to esophageal variceal hemorrhage,patients can divided into two groups: bleeding group(group A)and non-bleeding group(group B).The differences of the indexes in the two groups were compared and analyzed.Subsequently,analyze the Statistically significant indicators by Logistic multivariate regression and ROC curves to explore the risk factors for early postoperative rebleeding.RESULT: 1.A total of 498 patients were collected,including 92 cases in the bleeding group and 406 cases in the non-bleeding group;2.Sex(P=0.037),hypertension(P=0.022),age(A group: 53.65±9.56,group B: 57.84±10.30,P=0.006),Esophageal variceal red sign(P=0.006),gate pressure drug(P=0.032),albumin(A group : 29.48±6.33,group B: 31.58±5.06,P=0.016),prothrombin time(group A: 16.22±4.73,group B: 14.92±5.74,P=0.005),leukocyte(group A: 6.78±3.34,group B: 6.08±4.79,P=0.01),International Normalized Ratio(group A: 1.40±0.43,group B: 1.31±0.68,P=0.009),platelets(group A: 65.19±33.65,group B: 73.28±35.87,P = 0.045)and MELD(group A: 8.29±6.69,group B: 6.35±4.88,P=0.013),MELD-Na(group A: 9.39±8.02,group B: 7.23±5.85,P=0.039),MESO(group A: 0.61±0.50,group B: 0.46±0.35,P=0.015)were found by significance test.There was a statistical difference between the two groups(P<0.05).3.liver function classification(child-pugh classification),total bile acid,C-reactive protein,glutamyl transpeptidase,alkaline phosphatase,hemoglobin,serum sodium,total bilirubin,creatinine were found by significance test.If P>0.05 between the two groups,There was no significant difference.4.Multivariate logistic regression analysis revealed age(P=0.004),International standardization ratio(P=0.049),prothrombin time(P=0.038),Esophageal variceal red sign(P=0.034),were statistically significant(P<0.05).5.Using receiver operating characteristic curve to analyze the predictive value of MELD,MELD-Na,and MESO rebleeding within 6 weeks after ligation,the area under the ROC curve(AUC): 0.609(P=0.013),0.590(P=0.039),0.607(P=0.015),respectively,all statistically significant(P<0.05).Analyze the difference between three areas under the AUC curve,no statistically significant(P>0.05).CONCLUTION: 1.liver function classification(child-pugh classification),total bile acid,C-reactive protein,glutamyl transpeptidase,alkaline phosphatase,hemoglobin,serum sodium,total bilirubin,and creatinine were not associated with rebleeding within 6 weeks after ligation;2.Age,International standardization ratio,prothrombin time,Esophageal variceal red sign,were the independent risk factors for hemorrhage within 6 weeks after liver cirrhosis receives esophageal variceal ligation;3.MELD,MELD-Na,MESO can be used as predictors of rebleeding,and the predictive value of the three are similar;...