Analysis Of Related Risk Factors Of Rebleeding After Esophageal Varices Ligation In Patients With Liver Cirrhosis

Objective:Esophageal varices(EV)is a common complication of liver cirrhosis and a common cause of upper gastrointestinal bleeding.With the maturation and development of endoscopic technology,endoscopic varices ligation(EVL)has become the first choice for the prevention and treatment of esophageal varices bleeding(EVB).This study retrospectively analyzed the clinical data of patients with esophageal varices,aiming to analyze the risk factors of bleeding after the first ligation of esophageal varices,accurately identify and predict the high risk factors of bleeding after EVL,in order to improve the prognosis.Methods:The data of cases diagnosed with cirrhosis of esophageal varices or ruptured esophageal varices of cirrhosis in the affiliated hospital of Guilin Medical College from January 2012 to February 2019 were collected and analyzed retrospectively with EVL treatment,prevention or control of bleeding.According to whether rebleeding occurred after operation,they were divided into postoperative bleeding group and non-bleeding group.Clinical characteristics such as age,gender,Child-Pugh classification of liver function,degree of esophageal varices(Grade classification),red sign,etc.,plus the total number of ligation points,and patient compliance with endoscopic treatment for bleeding after EVL Analysis of related factors.The SPSS 20.0statistical analysis software was used to process the data,and the comparison of the measurement data conforming to the normal distribution was performed by the t test;the non-conforming group was analyzed by the Mann-Whitney U test.The x~2 test was used to compare the count data between groups.Single factor analysis was performed on each factor,and the factors with statistically significant differences were included in the multivariate logistic regression model analysis.Calculate the OR value of each independent risk factor and the95%CI of the OR value.The results are statistically significant with P<0.05.Results:A total of 95 patients were eligible for enrollment,of which 24had postoperative bleeding and 71 had no postoperative bleeding.A univariate statistical analysis of the collected clinical data showed that the Child-Pugh classification and the total number of band ligation points were statistically significant between the postoperative bleeding group and the non-bleeding group(P<0.05).Factors with statistically significant differences were included in the multivariate logistic regression model analysis,and the results showed that the Child-Pugh classification of liver function,the total number of band ligation and the red sign were statistically significant between the bleeding group and the non-bleeding group after EVL(P<0.05).Conclusions:Child-Pugh classification of liver function and red signs are independent risk factors for bleeding after EVL,and increasing the total number of ligation points(between1-30 points)is a protective factor after EVL.As the Child-Pugh classification of liver function increases,the possibility of postoperative bleeding increases;as the number of ligation points increases(increase within 1-30 points),the risk of postoperative bleeding decreases;patients with positive red signs are relatively the risk of postoperative bleeding is increased in patients with negative red signs(OR=7.490,95%CI=1.730-32.425).