A Comparative Study Of Endoscopic Variceal Ligation Combined With Sclerotherapy,Simple Ligation And Sclerotherapy In The Treatment Of Esophageal Variceal Bleeding In Cirrhosis

Objective:To compare and analyze the efficacy of endoscopic variceal ligation combined with sclerotherapy,simple ligation and sclerotherapy in the treatment of esophageal variceal bleeding.Methods:Patients with esophageal variceal bleeding in cirrhosis who were treated in our hospital from September 2016 to August 2018 were randomly divided into three groups: 32 cases were combination treated group(endoscopic variceal ligation+sclerotherapy sequential combination),30 cases were ligation group(ligation alone),and 30 cases were sclerotherapy group(sclerotherapy alone).Statistics of three methods in success rate of hemostasis(no bleeding 72 hours after treatment),complications after operation,the disappearance of varicose veins after the third treatment and recurrence of varicose veins after 6 months of follow-up were analyzed and compared with statistical methods.Results:There were no significant difference in mean age,sex ratio,etiology of liver cirrhosis,Child-Pugh grading of liver function and degree of esophageal varices among the three groups(P > 0.05).The number of successful hemostasis in the three groups was31,28,29 respectively.There was no significant difference among the three groups(P>0.05).The total number of complications after treatment in the three groups were 5,6 and 16 respectively.There was significant difference among the three groups(P < 0.05).The total number of complications among the three groups was compared in two or two ways.Therewas no significant difference between the combined group and the ligation group(P > 0.05).There was significant difference between the combined group and the sclerosis group and between the ligation group and the sclerosis group(P < 0.05/4).The total effective rates of the three groups after the third treatment were 96.9%,86.7% and 93.3%,respectively.There was no significant difference among the three groups(P < 0.05).After 6 months of follow-up,1case recurred in the combined group with a recurrence rate of 3.1%,12 cases recurred in the ligation group with a recurrence rate of 40.0%,and 3 cases recurred in the sclerosis group with a recurrence rate of 10.0%.The recurrence rate among the three groups was significantly different(P < 0.05).Conclusion:The group of endoscopic variceal ligation combined with sclerotherapy has reliable curative effect,fewer complications and less recurrence rate in the treatment of esophageal variceal bleeding in cirrhosis,which is worthy of clinical application.