Endoscopic Treatment Of Upper Gastrointestinal Bleeding In Liver Cirrhosis: An Analysis Of 102 Cases

Esophageal variceal bleeding is a fatal complication of liver cirrhosis.There is a growing recognition that the emergency gastroscopy and treatment is important.Endoscopic treatment should be completed as appropriate for patientswith upper gastrointestinal bleeding and liver cirrhosis.Objective: To evaluate the efficacy and safety of three endoscopic treatment(endoscopic variceal band ligation,endoscopic variceal sclerotherapy and endoscopic variceal obturationin)in upper gastrointestinal bleeding with liver cirrhosis.Methods:One hundred and two cases of patients with liver cirrhosis and upper gastrointestinal bleeding were seleted as observation in our research in the second hospital of hebei medical university during February 2014 to November 2018.Three groups are divided,which are endoscopic variceal sclerotherapy,endoscopic variceal band ligation and endoscopic variceal obturation.The outcomes assessed in this study were the hemostatic rate,early rebleeding rate,late-onset bleeding rate,hospital mortality and complication rates.The efficacy and safety are compared in endoscopic variceal sclerotherapy with endoscopic variceal band ligation.All patients were followed up for 3 months.Results:1.Efficacy of different endoscopic treatments: The hemostasis rate of endoscopic variceal band ligation,endoscopic variceal sclerotherapy and endoscopic variceal obturation was 94.9%(56/59),90%(27/30)and 91.7%(11/12).The rate of early re-bleeding(72h-6w)was 11.8%(7/59),3.3%(1/30)and 16.7%(2/12),and the rate of late re-bleeding(6w-3m)was 5.1%(3/59),6.7%(2/30)and 16.7%(2/12).2.Safety of different endoscopic treatments: The incidence of short-term complications(within 1 w)related to endoscopic treatment of endoscopic variceal band ligation,endoscopic variceal sclerotherapy and Endoscopic variceal obturation was 37.3%(22/59),33.3%(10/30),and 8.3%(1/12).Hospitalization mortality was 1.7%(1/59),10%(3/30),and 25%(3/12).3.Comparison of hemostasis rate,early bleeding rate,late re-bleeding rate,in-hospital mortality and complication rate of endoscopic variceal band ligation with endoscopic variceal sclerotherapy.There shows no statistical significance(P>0.05).Conclusion:1.Endoscopic variceal band ligation,endoscopic variceal sclerotherapy and endoscopic variceal obturation have high hemostatic rate,low early re-bleeding rate and late re-bleeding rate of cirrhotic varicose bleeding,slightly higher incidence of complications,complications are mild.2.There was no significant difference in the efficacy and safety between endoscopic variceal band ligation and endoscopic variceal sclerot-herapy.