| Esophageal-gastro varices bleeding(EGVB)is a natural process of the development of liver cirrhosis,and its incidence is 5%-15%.Among them,gastric varices bleeding(GVB)is more critical than esophageal varices bleeding(EVB).Once gastric varices bleeding(GV)ruptures,it will increase the mortality of patients.For clinicians,the treatment of GVB is still challenging.Endoscopic injection of tissue glue and sclerosing agent is safe and effective,and it has become the main treatment method for the treatment of GVB.However,a series of complications may occur after endoscopic injection of tissue glue and sclerosing agent,such as: varicose vein rebleeding,ectopic embolism,acute renal failure,injection site ulcers,bleeding and abdominal pain,abdominal distension,belching,and nausea,Acid reflux,etc.Sofalcone is a new type of gastric mucosal protective drug,which can dilate blood vessels,increase gastric mucosal blood flow,and reduce the occurrence of gastric ulcers.Objective:This project aims at investigating whether sofalcone can reduce the incidence of glue extrusion bleeding,ulcers at the injection site and clinical symptoms(abdominal pain,bloating,belching,nausea,acid reflux)after endoscopic treatment(modified sandwich method)of liver cirrhosis with gastric varices bleeding,providing more options for clinical treatment.Methods:From October 2018 to June 2020,110 patients with gastric varices bleeding from Department of Gastroenterology,Baoding First Central Hospital,were recruited into this study.All patients were diagnosed as liver cirrhosis with GV by imaging and electronic endoscopy and were treated by endoscopic therapies(endoscopic injection of tissue glue combined with lauric alcohol).Afterwards,proton pump inhibitors were injected intravenously for 3 days,then they were randomly divided into two groups according to the different ways of medication.Group A(control group)was given Esomeprazole Magnesium Enteric-coated Tablets 20 mg twice a day(30 minutes before meals),and group B(test group)was given sofalone 0.1g a day 2 times(30 minutes before meals)+Esomeprazole Magnesium Enteric-coated Tablets 20 mg 2 times a day(30 minutes before meals).Record the occurrence of clinical symptoms(abdominal pain,bloating,belching,nausea,acid reflux)during the medication period.Three weeks later,the electronic gastroscope was rechecked to observe the situation of the bleeding and ulcer at the injection site and the relief of clinical symptoms of the two groups of patients.Results:1.A total of 110 patients with liver cirrhosis and gastric varices rupture and bleeding were included in this study.There were 43 people in group A(control group),3 people did not complete the final follow-up,and 67 people in group B(test group),2 people did not complete the final follow-up.Final follow-up.There was no statistical difference between the two groups in gender,age,etiology of liver cirrhosis,liver function classification,biochemical examination and coagulation indexes(P>0.05).2.After 3 weeks of drug treatment,the electronic gastroscopy showed that 7 people in group A(control group)had glue extrusion bleeding,and the incidence of bleeding was 17.5%,while 2 people in group B(test group)had glue extrusion bleeding.The incidence was 3.07%.The incidence of glue extrusion bleeding in group B was significantly lower than that in group A b,with a P value of 0.027.The difference was statistically significant.3.After 3 weeks of drug treatment,the electronic gastroscopy showed that there were 6 people with ulcers at the injection site in group A(control group),and the incidence of ulcer at the injection site was 15%;While there was 1 person with ulcers at the injection site in group B(test group),the rate was 1.53%.Group B was significantly lower than group A,P value was0.022,the difference was statistically significant.4.After 3 weeks of drug treatment,the clinical symptoms situations between two groups of patients: the P values of abdominal pain,abdominal distension,belching,nausea,and acid reflux were 0.014,0.013,0.981,0.044,0.649,respectively.It can be concluded that relief situation of abdominal pain,abdominal distension and nausea in group B(test group)was significantly better than that in group A(control group)(P<0.05),while the relief of belching and acid reflux was not statistically significant between two groups(P>0.05).Conclusion:1.Sofalcone is a new gastric mucosal protective drug,which can promote mucosal repair and reduce postoperative bleeding and ulcers at the injection site.2.Compared to the control group,Sofalcone treatment group has a relieving effect on postoperative abdominal pain,bloating,nausea and other symptoms but has no significant improvement on belching and acid reflux. |
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