Endoscopic Injection Sclerotherapy Effects On The Systemic Coagulation Of Liver Cirrhosis Patients With Esophageal Varices

Objective:Observation of changes of blood coagulation indicators in hepatic cirrhosis patients with esophageal varices after injection sclerotherapy, to explore the treatment of injection sclerotherapy on blood coagulation in hepatic cirrhosis patients, to clear relationship between coagulation changes and Child-Pugh classification of liver function after operation. In order to in a suitable period of the intervention, to prevent or reduce the occurrence of complications.Methods:The object of study is patients diagnosed with hepatic cirrhosis and esophageal varices indications of endoscopic injection sclerotherapy in the Fujian Provincial Hospital digestive department ward during February 2015 to February 2016, after hospitalization according to Child-Pugh classification they are divided into A, B, C three groups. Preoperative and postoperative 24 hours and 72 hours and 7 days in the morning fasting venous blood check coagulation indexes (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen,Antithrombin Ⅲ and D-dimer). Compared preoperative postoperative coagulation index changes, observed digestion, breathing, nervous system, facial features, skin petechia ecchymosis organs, bleeding tendency; and compared the changes of blood coagulation indicators between the three groups if there is a difference.Results:1-. Changes of coagulation indexes in all patients before and after endoscopic sclerosis therapyAll patients with cirrhosis agent 1,3,7 days after therapy and sclerotherapy in the treatment of preoperative (day 0) compared to 3 days after the operation of Pt compared with preoperative prolonged (P<0.05),1,3 days after the operation of FIB is preoperative decreased significantly (P<0.05), postoperative day 1,3 DD compared with preoperative increased (P<0.05), are statistically significant.Comparison of the preoperative and postoperative appear index difference and the difference of child Pugh classification:PT0-3 (preoperative day 0 and after the third difference, the following symbols and so on), FIB0-1, FIB0-3, DD0-1, DD0-3 five index value according to child-Pugh classification compared, we five indicators of difference between the different child Pugh score no statistical difference (P>0.05).2^ Changes of coagulation indexes before and after treatment with different Chilld-pugh gradingThe 1,3,7 days after Child-pugh A group and B group patients hardening agent in the treatment of, (0d) compared to before treatment, postoperative day 3 PT values than before treatment (0d) increased (P<0.05); postoperative day 1,3 FIB compared with those before treatment decreased (P<0.05); postoperative day 1,3 DD compared with those before treatment significantly increased (P<0.05).The 1,3,7 days after Child-pugh C group in patients with sclerotherapy, with (0d) compared to before treatment and after sclerotherapy at 3,7 days PT values than before treatment increased (P<0.05); compared with before treatment, after treatment of 1,3 and 7 days of FIB decreased (P<0.05); postoperative day 1,3 DD compared with those before treatment significantly increased (P<0.05).Conclusion:Esophageal varices hardener treatment does not affect liver function in the short term, but can lead to blood coagulation and fibrinolytic indexes briefly, reversible changes, this change has no obvious relation with liver function classification, recommend hardener postoperative monitoring blood coagulation indexes in the short term, when it is necessary to give input, plasma prothrombin complex intervention treatment.