| Objective:1.A 10-year retrospective analysis of the number and classification of endoscopic diagnosis of isolated gastric varices in our hospital,and determine the endoscopic detection rate and constituent ratio of IGV in our hospital.2.By comparing the efficacy and safety of endoscopic techniques in the treatment of isolated gastric varices in cirrhotic and non cirrhotic,and get the best endoscopic treatment plan,so as to provide a strong basis for further diagnosis and treatment of isolated gastric varices.3.The value of CTP,MELD,MELD-Na and other related indicators before endoscopic treatment can predict the value of endoscopic treatment for recurrent bleeding and bleeding related death of isolated gastric varices in cirrhotic,and early intervention for IGV patients can reduce death and ameliorate prognosis.Methods:From January 2008 to December 2017,we enrolled the patients who undergo endoscopic examination,187 patients who were diagnosed as isolated gastric varices and treated by endoscopy.Endpoint was treated by endoscopy for about 1 years.According to the presence of liver cirrhosis were divided into cirrhosis group(167 cases)and non cirrhosis group(20 cases),according to whether there is bleeding subgroup bleeding(32 cases)and non bleeding(135 cases)of IGV in cirrhosis group,bleeding(6 cases)and non bleeding(14 cases)of IGV in non cirrhosis group,which were compared between the two groups of basic data,endoscopic diagnosis of IGV number and type,CTP grade,MELD score,MELD-Na score,endoscopic treatment,endoscopic characteristic(erythema,erosion,blood clots and thrombosis),anesthesia,time of surgery,Operator,hemostatic rate immediately and within 5 days,rebleeding rate within 6 weeks and 1 year,mortality rate within 6 weeks and 1 year.By drawing the line chart and stacked bar chart evaluation IGV detection rate and composition change tendency ratio in our hospital in recent ten years;By using statistical methods to obtain the efficacy and safety of endoscopic treatment of IGV in liver cirrhosis and non cirrhosis;By calculating the area under the ROC curve of the score prediction of the value of the rebleeding and rebleeding related mortality after the endoscopic treatment of IGV in liver cirrhosis.Results:1.The total detection rate of IGV in our hospital in the last ten years is about 0.14%,the proportion of IGV1 is 85-90%,the constituent ratio of IGV2 is 5-10%,and the proportion of IGV1 with IGV2 is 5-10%.2.Whether IGV in cirrhosis bleeding or non bleeding group,tissue glue treatment in bleeding rate within 6 weeks were less than ligation(P<0.05);spring coil compare to other groups,tissue glue combined sclerotherapy compare to tissue glue in rebleeding rate and mortality rate(within 6 weeks and 1 year)were no statistical difference(P>0.05).IGV in cirrhosis bleeding group,rebleeding rate within 1 year and mortality rate within 6 weeks after the tissue glue treatment were less than those of ligation and sclerotherapy(P<0.05).There were no significant difference in the rebleeding rate and mortality rate(within 6 weeks and 1 year)between spring coil compare to sclerotherapy and ligation compare to sclerotherapy(P>0.05).IGV in the cirrhosis non bleeding group,rebleeding rate within 6 weeks and mortality rate within 1 year after the tissue glue treatment were less than those of ligation(P<0.05).There were no significant difference in the rebleeding rate and mortality rate(within 6 weeks and 1 years)between the tissue glue and the tissue glue combined sclerotherapy treatment between IGV in the bleeding group and the non bleeding group(P>0.05).3.There were no significant difference in the rate of rebleeding and mortality(within 6 weeks and 1 year)between tissue glue and tissue glue combined sclerotherapy treatment of IGV in the non cirrhosis bleeding group(P=0.62).IGV in the non cirrhosis non bleeding group,rebleeding rate within 1 year after the tissue glue treatment were less than ligation.There were no statistically significant difference in the rebleeding and mortality rate(within 6 weeks and 1 year)between IGV in the non cirrhosis bleeding group and the non bleeding group(P>0.05).4.According to the area under the ROC curve,compare the endoscopic treatment of IGV patients in liver cirrhosis in the rebleeding rate and mortality rate(within 6 weeks and 1 year)MELD-Na>CTP(P<0.05),MELD>CTP and MELD-Na>MELD in the rebleeding rate and mortality rate(within 6 weeks and 1 year)after the endoscopic treatment of IGV in cirrhosis,while there were no significant difference.Conclusions:1.The total detection rate of IGV in our hospital in recent ten years is about 0.14%.2.IGV patients in cirrhosis tissue were treated with endoscopic tissue glue and tissue glue combined sclerotherapy treatment.3.Endoscopic tissue glue treatment had the best effect in IGV of non cirrhotic.4.MELD-Na score can predict the endoscopic treatment of IGV patients in liver cirrhosis in rebleeding and bleeding related death more accurately than CTP grading. |
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