| ObjectiveThe purpose of the present paper was to investigate the clinical, endoscopic features and laboratory examinations of 48 patients with esophageal varies in hepatic cirrhosis who received polidocanol sclerotherapy to enable the risk factors in predicting the early hemorrhage.Method48 patients with esophageal varies of hepatic cirrhosis who received polidocanol sclerotherapy were involved in this investigation in Department of Gastroenterology of the Second Hospital Affiliated to Soochow University from December 2012 to December 2015.The cases were divided into bleeding group and non bleeding group according to six weeks after treatment with and without active hemorrhage. Analysis in sclerotherapy for esophageal variceal hemorrhage included the general information, medical history,laboratory examination and endoscopic sclerotherapy treatment process and postoperative complications, etc. All the information was recorded on the Microsoft Excel 2007 for Windows to establish the database. The statistical data were treated by SPSS 17.0processing including quantitative data by T test and qualitative data by chi-square test.Logistic regression analysis of the single factor and multiple factors deduced the independent risk factors. The receiver-operating characteristic curve(ROC) area under curve(AUC) was calculated to evaluate the value for early hemorrhage after polidocanol sclerotherapy in esophageal varies of hepatic cirrhosis.Result1. There were 48 patients with esophageal varies hemorrhage and all received polidocanol sclerotherapy only once under investigation in the group. The male were 14 cases,and the female were 34 cases. The mean age was 55±13 years old. Hemorrhage occurred in 7 cases within 6 weeks of polidocanol sclerotherapy, and the early hemorrhage rate was 14.6%. Among them 3 patients cured uneventfully for a short time after medicine conservative treatment, but the others recovered from an interventional treatment of TIPS.2. There were statistical significance in the history of bleeding(P= 0.033), PLT(P=0.04), serum albumin(P= 0.004), PT(0.043) and Child-Pugh score(P= 0.017), while other aspects such as sex, age, the degree of varicose veins, the WBC, HB, % N, K, A/G, AST,ALT, TB, ALP, r-GT, CHE, FDP, PTA, INR, MELD score and endoscopic therapy appeared no statistical significance(P>0.05) between the bleeding group and non bleeding group.3. Single factor Logistic analysis showed that the history of bleeding, hepatic encephalopathy, PLT, serum albumin, Child score were the risk factors for early bleeding(P<0.05). Multivariable Logistic regression analysis showed that the history of bleeding and albumin were the independent risk factors for early hemorrhage. Serum albumin and history of bleeding area under curve(AUC) were 0.829(P=0.06) and 0.678(P = 0.136).Conclusion1. The history of bleeding, hepatic encephalopathy, platelet, serum albumin,preoperative Child-Pugh score were the impact factors early hemorrhage after polidocanol sclerotherapy in esophageal varies. The serum albumin and history of bleeding were the independent risk factors for early hemorrhage.2. Serum albumin might effectively judge the prognosis of varices early hemorrhage after endoscopic injection sclerotherapy in esophageal varies of hepatic cirrhosis. |
