Follow-up Of Endoscopic Variceal Dense Ligation Combined With Endoscopic Injection Small Does Sclerotherapy For Severe Gastroesophageal Varices Of Cirrhosis

Objective: evaluate the efficacy of endoscopic variceal dense ligation combined with endoscopic injection small does sclerotherapy for severe gastroesophageal varices,and to follow up and observe after the treatment.Methods:1 Patients with liver cirrhosis admitted to the Department of Gastroenterology of The Second Hospital of Hebei Medical University from January 2013 to December 2016,severe gastroesophageal varices were diagnosed by gastroscopy,conducted endoscopic variceal dense ligation combined with endoscopic injection small does sclerotherapy.2 Count the basic information of the study object,the course of disease,the treatment of ligation and sclerotherapy,esophageal and gastric varices disappeared,preoperative and intraoperative bleeding and complications.3 Count the result of followed up for 3 months,6 months and 12 months for the patients after the treatment.4 To observe the liver function of Child-Pugh grade for the liver cirrhosis before and after treatment.Results:1 There were 46 liver cirrhosis patients who had gastroesophageal varices in The Second Hospital of Hebei Medical University from January 2013 to December 2016,among those patients,28 males and 18 females,male:female is 1.56:1;with an a average age of(55.33±9.28)(32-74 years old).2 46 patients in this study,the rate of hemostasis was 100% in 32 patients after medical and endoscopic treatment,esophageal varices of 42 patients were cured(91.31%)(the disappearance / the basic disappearance),with the disappearance of varicose veins in 9 patients(n = 19.57%),and the basicdisappearance of varicose veins in 33 patients(71.74%).Gastric varices of 39 patients were cured(84.78%).3 In this study,17 cases of bleeding during treatment and follow-up for gastroesophageal varices(15 patients,2 of those patients were bleeding for 2times).4 Only one time for endoscopic variceal dense ligation,from the perspective of esophageal treatment,varicose vein disappeared / disappeared basically reached 9.52%(4/42);multiple ligation to varicose vein disappeared/ disappeared basically reached 40.48%(17/42),and varicose veins disappeared and disappeared basically reached(50%)(21/42).Only one time for endoscopic variceal dense ligation for gastric varices,from the perspective of the bottom of stomach treatment,varicose vein cured could reach 61.54%(24/39);endoscopic injection sclerotherapy for just one time could cure2.56%(1/39);multiple ligation simply achieved 17.95%(7/39);ligation combined with injection small does sclerotherapy,varicose vein cured could reach 17.95%(7/39).5 The main adverse reactions were throat discomfort,pain of substernal,fever,nausea,vomiting,ulcers,dysuria and other discomfort.6 The Child-Pugh score after endoscopic variceal dense ligation combined with endoscopic injection small does sclerotherapy was lower than that before the treatment,the difference had statistical significance(P<0.05).7 From the perspective of esophageal treatment,among the 42 patients of varicose vein disappeared / disappeared,followed up for 3 months,6 months,12 months after the treatment were 50%(21/42),42.86%(18/42),21.43%(8/42),patients who were followed-up for 3 months,6 months and 12 months were not required to treat with endoscopic intervention at the rate of 47.61%,38.89%,and 12.50%.From the bottom of stomach treatment,among the 39 patients of gastric varices cured patients,followed up for 3 months,6 months,12 months after the treatment were 69.23%(27/39),58.97%(23/39),53.85%(21/39),without endoscopic intervention after 3 months of follow-up,6 and 12 months in patients with 85.19%,65.22%,47.62%.Conclusion: Endoscopic variceal dense ligation combined with endoscopic injection small does sclerotherapy for gastroesophageal varices is effective,with high eradication rate,low rate of rebleeding,low recurrence rate of varicose veins and slight adverse reactions.Only one time for endoscopic variceal dense ligation for esophageal varices got poor therapeutic effect,repeated endoscopic treatment can rapidly improve the efficacy of varicose veins;Only one time for endoscopic variceal dense ligation for gastric varices got bttter therapeutic effect,but ligation combined with sclerotherapy can further improve the curative effect.The liver function was improved after the endoscopic variceal dense ligation combined with endoscopic injection small does sclerotherapy treatment.