The Curative Effects Of Different Treatment In Patients With Esophageal Gastric Varice Hemorrhage

ObjectiveTo explore the therapeutic effect of liver cirrhosis esophagogastric varices bleeding by the following three different treatments:pericardial devascularization (splenectomy with periesophagogastric devascularization), endoscopic variceal ligation, and drug therapy, offering scientific evidences for clinical treatment to the liver cirrhosis bleeding.MethodsTo analysis 120 upper gastrointestinal hemorrhage patients from the third people’s hospital of jinan from 2008 to 2013, who were diagnosed to be liver cirrhosis esophageal gastric varices bleeding through clinical examination, medical history, ultrasound, laboratory examination and gastroscopy diagnosis. After initial hemostasis,,the patients were divided into three groups: endoscopic variceal ligation group (49 cases), pericardial devascularization group (41 cases) and drug therapy group (30 cases), we tried to compare the changes of liver function and PLT before and after those three treatments, following up the laboratory indexes’ changes.rebleeding rate.mortality rate after 1 month,6 months and 1 year.ResultsThe TBIL and ALT of pericardial devascularization were increased,the ALB was decreased after one months, but the other two groups had no statisticial difference. Those indicators had no significance difference six months and a year later, though the PLT was increased after one months, And at 6 months,1 year is gradually rising trend, the difference was statistically significant(P<0.01). The other two groups of patients before and after treatment PLT determination results no statistical difference (P>0.05). The rebleeding rate of pericardial devascularization((7.31%,12.20%,17.07%)was lower than endoscopic variceal ligation(14.29%, 18.37%,22.45%) after one month, six months,1 year, the difference was statistically significant(P<0.01).which drug group was higher than the other groups after one month, six months,l year(P<0.01).The mortality rate of pericardial devascularization and endoscopic variceal ligation were 4.88% and 6.12%, which had no statistic difference, but were lower than the drug group (13.33%, P<0.01)Conclusion(1) Aamong these three groups,the postoperative liver function of the pericardial devascularization group was discreased obviously, the ligation group and the drug group had no obvious change in liver function;(2) The PLT of the pericardial devascularization group had increased to normal or higher than normal was discreased obviously, the ligation group and the drug group had no obvious change in liver function;(3) The rebleeding rate of the pericardial devascularization group was the lowest;(4) The rebleeding rate and mortality of the pericardial devascularization group and the ligation group were better than that of drug treatment.