Clinical Features,Endoscopic Diagnosis And Prognosis Of Esophageal Varices And Type 2 Gastroesophageal Varices With Or Without Type 1 Gastroesophageal Varices

OBJECTIVE:Retrospective analysis of the clinical features,endoscopic findings and efficacy of primary and secondary prophylaxis for esophageal varices and GOV2 with or without GOV1 varices,and analyze risk factors associated with 6-week and 1-year rebleeding.Methods:Collected 2009.01.01-2018.10.31 to our hospital digestive endoscopy center for gastroscopic diagnosis of esophageal varices and GOV2 with or without GOV1 varices in total 228 cases,compared EV+GOV2 with EV+GOV1+GOV2 the detection rate and constituent ratio of the patients.The relevant medical history,physical signs,clinical examination indexes,endoscopic performance and treatment methods of 129 patients undergoing endoscopic treatment were recorded.The follow-up period was 1 year.The 6 weeks and 1 year rebleeding of risk factors was analyzed.Results:1.The total detection rate of EV+GOV2 and EV+GOV1+GOV2 is increasing year by year.The constituent ratio of EV+GOV2 is higher than EV+GOV1+GOV2 during 2009-2017,and the result is opposite in 2018.2.129 patients underwent endoscopic treatment.There were 5 patients with EV+GOV2 in primary prophylaxis.The main cause was hepatitis B-related cirrhosis,and all were treated with EBL.In secondary prophylaxis,EV+GOV2 had no statistical difference in endoscopic findings(variceal diameter,erythema,traffic branch,thrombus,active bleeding,treatment)and clinical features compared with EV+GOV1+GOV2.3.There were no rebleeding and death patients who underwent primary endoscopic treatment for 6 weeks and 1 year;124 patients who underwent secondary endoscopic treatment,1(0.8%)failed to stop bleeding,no patients died within 6 week and one patient died within 1 year.4.Univariate analysis found that 6-week rebleeding were associated with EV+GOV1+GOV2、age、 PT、total bilirubin,CTP grade,MELD score,hepatic encephalopathy,and post-hospital transfusion therapy.Multivariate analysis indicated that age,EV+GOV1+GOV2,and total bilirubin were independent risk factors for rebleeding within 6 weeks,with EV+GOV1+GOV2 being the most significant.One-year rebleeding is associated with the cause of cirrhosis,platelet,and endoscopic treatment.Conclusion:1.The detection rate of EV+GOV2 and EV+GOV1+GOV2 in our hospital gradually increases,and the total constituent ratio of EV+GOV2 is higher than EV+GOV1+GOV2.2.Endoscopic treatment is effective treatment of esophageal varices and GOV2 with or without GOV1 varices;3.Risk factors for re-bleeding within 6 weeks in patients with secondary prophylaxis may be associated with varices were classified as EV+GOV1+GOV2、age、PT、total bilirubin、CTP grade、MELD score、hepatic encephalopathy and post-hospital transfusion therapy.Age、EV+GOV1+GOV2 and total bilirubin were independent risk factors for rebleeding within 6 weeks,EV+GOV1+GOV2 was the most significant;cirrhosis etiology、platelet、endoscopic treatment is related to 1 year rebleeding.