Study On Efficacy Of Endoscopic Ligation And Sclerotherapy For Gastroesophageal Varices And Risk Factors For Prognosis

Objective:1.Follow-up study of patients undergoing endoscopic ligation and sclerotherapy for gastroesophageal varices and assessment of efficacy and prognosis objective.2.Our arms were to select the influencing factors that associated with prognosis and explore the clinical significance of these factors.Methods:A retrospective study of 87 patients with gastric varices from the Department of Gastroenterology of Second Hospital Affiliated of Hebei Medical University between January 2014 to January 2018.We collected all information of patient,such as serological results,endoscopic characteristics of gastric varices and endoscopic treatment methods.All patients received follow-up examinations of effect and prognosis after the therapy.Analsis was done by SPSS 23.And we established a predictive model to determine the independent risk factors.Furthermore,we evaluated the clinical predictive value by using the receiver operating characteristic curve(ROC).Results:1.During the follow-up period,the effective rate after initial ligation was 73.6%.A total of 14 patients(16.1%)appeared esrly bleeding,12 patients(13.8%)appeared long-term bleeding and 8 patients(9.2%)appeared recurrence after treatment.2.Binary logistic regression multivariate analysis showed white blood cell count,blood sodium,ascites and the degree of gastric varices were independent factors for the ineffectiveness after initial ligation,and these factors can be used to calculate the risk score.3.Survival analysis showed that hemoglobin and serum total bilirubin were independent risk factors for postoperative bleeding,and the serum total bilirubin was better than hemoglobin.4.Survival analysis showed that hypertension was an independent risk factor for relapse after treatment.In addition,alanine aminotransferase and aspartate aminotransferase can effectively diagnose recurrence.Conclusions:1.Endoscopic ligation and sclerotherapy for gastroesophageal varices is an effective treatment.2.White blood cell count,blood sodium,ascites,the degree of gastric varices,hemoglobin,serum total bilirubin,hypertension are independent risk factors for prognosis.