Emergency Hemostatic Effect Of Metal Clip Combined With Sclerotherapy In The Treatment Of Acute Esophageal Variceal Bleeding Under Endoscopy

ObjectiveTo investigate the emergency hemostatic effect of metal clip combined with sclerotherapy and simple sclerotherapy in the treatment of acute esophageal variceal bleeding in patients with liver cirrhosis under endoscopy.MethodFrom August 2012 to December 2018,52 patients with acute esophageal variceal bleeding in patients with liver cirrhosis who underwent endoscopic treatment in the affiliated Hospital of Hangzhou normal University were analyzed retrospectively.Among them,21 cases were treated with metal clip combined with sclerotherapy as treatment group and 31 cases with simple sclerotherapy as control group.The treatment group was treated with metal clip to close the bleeding site of varicose vein,followed by sclerosing agent varicose vein injection,while the control group was treated with sclerosing agent varicose vein injection alone.The hemostatic time,the success rate of immediate hemostasis(sum of apparent effective rate and effective rate),the success rate of emergency hemostasis and the rate of short-term rebleeding were compared between the two groups.At the same time,the incidence of short-term complications in the two groups was evaluated.ResultThe hemostatic time in the treatment group was shorter than that in the the control group(t=-8.547,P=0.000),and the immediate hemostatic effective rate(?2=7.523,P=0.006)and the success rate of emergency hemostasis(?2=4.576,P=0.032)were higher than those in the the control group.The difference between the treatment group and the control group was statistically significant.There was no significant difference in the success rate of immediate hemostasis(?2=0.667,P=0.414)and the rate of short-term rebleeding(?2=0.744,P=0.388)between the two groups.The incidence of deep esophageal ulcer in the treatment group was lower than that in the the control group(?2=4.146,P=0.042),and the difference was statistically significant.There was no significant difference in the incidence of short-term complications such as fever(?2=0.964,P=0.326),retrosternal pain(?2=0.425,P=0.514),nausea(?2=0.248,P=0.619)and upper abdominal discomfort(?2=0.667,P=0.414)between the treatment group and the control group.ConclusionMetal clip combined with sclerotherapy has the advantages of short hemostatic time,rapid immediate hemostasis,high success rate of emergency hemostasis,and rare formation of deep esophageal ulcer in a short period of time.The curative effect of emergency hemostasis is better than that of simple sclerotherapy.It can be used for hemostatic treatment of esophageal variceal bleeding in LDRf classification D1.0,which is worthy of reference by clinicians.