Retrospective Analysis Of Endoscopic Variceal Ligation In The Treatment Of Esophageal Variceal Bleeding In Liver Cirrhosis

Objective: To compare different intervals under endoscopic ligation(EVL)for the treatment of esophageal variceal bleeding(EVB)clinical efficacy and complications,to explore the relationship between the set of rebleeding during EVL intervals and ligation of esophageal variceal bleeding in cirrhotic patients.To explore the methods to reduce the EVB bleeding rate and prevent complications to summarize the clinical experience.Methods: A retrospective analysis of 115 hospitalized patients with esophageal variceal bleeding(EVB)who underwent esophageal variceal ligation(EVL)from May 2013 to February 2017 in the First Affiliated Hospital of Guangxi University of traditional Chinese medicine was carried out.According to the interval between the first time and the second EVL interval,they were divided into three groups: 1 months,2 times,EVL for A group,2 months to 3 months interval 2 times EVL for B group,6 months to 12 months interval 2 times EVL for C group.Record the clinical data of three groups(including age,gender,etiology of cirrhosis,the main clinical laboratory examination),esophageal varices grading,second EVL postoperative complications,follow-up of three groups of the total rate of rebleeding(including 3 months,6 months,12 months after operation)and the incidence and mortality of the complications.Statistical methods were used to deal with and analyze.Result:1.The clinical data of the patients in the three groups of gender,age,etiology of cirrhosis,varices,liver function grading,clinical laboratory examination(albumin,total bilirubin,prothrombin time,AST,ALT)on P >0.05,the difference was not statistically significant,comparable.2.Second EVL esophageal varices: the moderate of the three groups of esophageal varices were 52.5%,23.8%,9.1%.the severe of 47.5%,76.2%,90.9%,respectively,P<0.05.The difference was statistically significant,indicating that the three groups after the first treatment in esophageal EVL to second times EVL treatment the effective rate of varices is different.Three groups were compared in each group: A group and B group,P<0.05/3,the difference was statistically significant.A group and C group had significant difference(P<0.05/3).B group compared with C group,P>0.05 had no significant difference.The clinical efficacy of group A(interval within 1 months)was better than that in group B(2-3 months interval)and group C(6-12 months).The clinical effect of group B and group C was not very different.3.The rebleeding rate of the three groups: the total bleeding rate was 10%,33.3%,60.6%,P<0.05,the difference was statistically significant,indicating that 2 EVL treatment interval for rebleeding rate different.Three groups were compared in each group,A group and B group,P<0.05/3,the difference was statistically significant.Compared with A group P<0.05/3,with the C group,the difference was statistically significant.Compared with B group,C group and P>0.05/3,the difference was not statistically significant.The rebleeding rate in group A(1 months interval)was lower than that in group B(2-3 months)and group C(interval 6-12 months),and the rebleeding rate in group B and C group was not significant.3 months after operation,the bleeding rate was 50%,35.7% and 30% respectively.The bleeding rate was 25.5%,35.7% and 35% at 6 months after operation.And 12 months after operation,the bleeding rate was 25.5%,28.6% and 28.6% respectively after operation,and the average P >0.05.4.The incidence and mortality of the complications:(1)three fever group were 8 cases,8 cases,10 cases.Chest tightness or chest pain were 4 cases,3 cases,5 cases.Sense of dysphagia was 8 cases,11 cases,7 cases,P>0.05.there were no significant differences among them.Postoperative fever and swallowing obstruction is a common adverse reaction.(2)Death cases: the number of death cases in the three groups were 5 cases,3 cases,3 cases,P>0.05,the difference was not statistically significant.Conclusion: For patients with EVB,the effective rate of esophageal varices in interval of 1 months is 2 times EVL interval,and the effective rate of esophageal varices is longer than that of interval.The longer the time of ligation,the higher the recurrence rate of esophageal varices.In the rebleeding rate,the rebleeding rate in the 1 month interval was significantly lower than that in the longer interval group.That is,the longer the interval interval of EVL interval,the higher the rebleeding rate.The rebleeding rate is not significantly related to the duration of treatment.Therefore,it should be recommended in clinical practice to improve the quality of life of the patients.