| Objective:esophago-gastric varices bleeding (EGVB) is one of most common and serious complication of portal hypertension, the high mortality caused by rapid development, large amount of bleeding and high rebleeding rate. Rapid and effective control EGVB and prevent its recurrence is a fundamental goal of reducing mortality in clinical treatment. In this paper, by comprehensive analyze percutaneous transhepatie variceal embolization (PTVE) combined octreotide in treatment of EGVB in patients with Live Cirrhosis Portal Hypertensive, to explore the clinical value of this method. And to study the correlation factors of impact EGVB rebleeding and survival, to explore a comprehensive and effective treatment for clinical in treating EGVB and preventing of rebleeding.Materials and Methods:Collected47hospital patients of diagnosed with cirrhosis portal, hypertension EGVB and treatmented by PTVE combined octreotide between January2008-January2013, which is defined as the combined treatment group, and select56patients of treatmented by octreotide alone as a control group in the corresponding period. though comparing the two groups in initial success rate of hemostasis, the time required to stop bleeding, blood transfusion, three months, six months and one year rebleeding rate, response rate of varicose veins and annual survival rates, to analyze the Clinical effect and adverse reactions, and the correlation of treatment, gender, age, etiology, varicose veins indexing, classification, Child grading and re-bleeding and survival.Results:1. The results of this study shows that the combined treatment group47 cases of successful hemostasis. success rate was100%. the control group hemostasis in44cases, success rate was78.6%within72hours; required average time of hemostasis in combined treatment group7.03+0.537, in the control group18.32±7.873; average blood transfusion of during treatment in combined treatment group1.84±1.194and control group3.68+1.600; all above differences were statistically significant (P<0.05). After treatment, follow-up3months to1year, combined treatment group re-bleeding rate of three months, six months and one year was2.1%(1/47),6.4%(3/47),14.9%(7/47), respectively; the control group was23.2%(13/56),33.9%(19/56),51.8%(29/56), respectively; the difference was statistically significant (P<0.05). In the follow-up of1year, the combined treatment group33cases of varicose veins disappear, reducing the nine cases, the treatment effective rate was89.3%, in the control group,10cases of varicose veins disappear, reducing the16cases, the effective rate was46.6%, the difference was statistically significant (P＜0.05).2. Logistic multivariate regression analysis showed that. Child-pugh classification, esophageal varices indexingand esophageal varices typewererisk factors of rebleeding, cox regression analysis revealed the treatment and Child-pugh classification were reliable affect factors of rebleeding. Log-rank test and Kaplanes-Meier survival curves showed higher survival rate of the combined treatment group, the difference was statistically significant (P<0.05). Cox multivariate regression analysis showed treatment and Child-Pugh classification were reliable affect factorsof the survival.3. The follow-up year, the combined treatment group died2cases,10deaths in the control group, the mortality rate was not statistically significant groups (P0.05).Conclusion:1. PTVE combined octreotide treatment of liver cirrhosis and portal hypertension EGVB compared with octreotide alone, have a higher success rate of hemostasis (100%vs78.6%) and effective rate of varicose veins treatment (89.3%vs44.6%), lower rebleeding rate(14.9%VS51.8%), showed that the clinical efficacy of PTVE combined octreotide was superior to octreotide therapy alone. And compared with medical therapy alone, the hemostasis time of combined treatment shortened Obviously, but also reduces the average amount of blood transfusionsignificantly, to better improve the quality of life of patients and is worthy of further study.2. the complications of the combined treatment group compared with octreotide therapy alone group and more, but not severe complications with life-threatening in patients, all complications were cured or mitigated in the short-term treatment, did not affect the outcome.3.in terms of survival, the survival rate of patients with the combination therapy group improved significantly. |
PDF Full Text Request