| Background:With the continuous development of endoscopic technology,new technologies related to endoscopic treatment have been gradually developed.More and more targeted endoscopic treatment methods for different types of cirrhosis of esophageal varices have been recognized by everyone.At present,the most representative treatment methods include ligation of esophageal varices,endoscopic sclerotherapy and tissue adhesive injection.Ligation or sclerotherapy are often used for esophageal varices alone,while tissue adhesive injection is often used for single gastric varices.However,it is still unclear that there are varices at the same time Therefore,the purpose of this study is to compare the therapeutic effects of three endoscopic methods of GOV I with varicose veins in the fundus of esophagus and stomach.In group one,the esophagus was ligated and the fundus of stomach was not treated;in group two,the fundus of stomach was injected with tissue adhesive;in group three,the fundus of stomach was treated with tissue adhesive as well as in group two,and the esophagus was injected with sclerosing agent.Because the main disease of esophagogastric varicosity is caused by cirrhosis,when the primary disease is not treated significantly,esophagogastric varicosity may recur at any time,requiring repeated endoscopic treatment,and the quality of life of patients is seriously affected by the number of hospitalizations,length of stay,and cost of hospitalization.Therefore,in view of these three treatment methods,the curative effect and adverse reactions and the incidence of rebleeding will be compared.By comparing the times of hospitalization,length of stay and cost of hospitalization,we can evaluate which treatment method can achieve rapid recovery and quality of life.Objective:Through retrospective analysis,three endoscopic treatment methods of esophagogastric varices were discussed,and the curative effect,rebleeding rate,adverse reactions,hospitalization times,total hospitalization time and total hospitalization expenses were compared.Then,which treatment method is more suitable for gov1 patients,so as to improve the quality of life of patients and achieve the treatment effect of rapid rehabilitation.Methods:From September 2017 to June 2019,patients with esophageal and gastric varices treated by endoscopy in our hospital were divided into three groups: group 1: endoscopic variceal ligation(EVL)treatment,group 2: EVL combined with endoscopic tissue adhesive injection,group3: endoscopic injection sclerotherapy,(EIS)combined with endoscopic tissue adhesive injection,through the comparison of its efficacy,the incidence of rebleeding and adverse reactions and other indicators,to determine which treatment method is more suitable for the treatment of esophageal and gastric varices GOV1 type,through the analysis of the total hospitalization cost,total hospitalization time,number of hospitalization and other variables,to evaluate the advantages and disadvantages of three treatment methods in improving the prognosis and recovery time of patients.Spss20.0 software was used for statistical analysis.If the measurement data conform to the application mean ±standard deviation of normal distribution,the application median of non normal distribution was used.Among the three groups,F test was used for normal distribution and square difference,rank sum test was used for unsatisfied,chi square test was used for qualitative data,if the theoretical frequency was less than 1,likelihood ratio test was used,p<0.05 was statistically significant.Results:A total of 162 patients with esophageal varices were enrolled in the study,85 patients in group 1,aged 55(49,63),including 64 males and 21 females,59 patients with viral cirrhosis,17 patients with alcoholic cirrhosis,9 patients with other causes,38 patients with child Pugh grade B,47 patients with grade C,19 patients with moderate varices and 66 patients with severe varices;54 patients in group 2,aged 55(47,62)years old,including 33 males and 21 females,37 patients with viral cirrhosis,13 patients with alcoholic cirrhosis,4 patients with other causes,22 patients with child Pugh grade B,32 patients with grade C,12 patients with moderate varicose veins,42 patients with severe varicose veins,23 patients in group 3,age 56(49,63)years old,including 15 males and 8 females.The main causes were viral cirrhosis(15 cases),alcoholic cirrhosis(5 cases),other causes(3 cases),child Pugh grade B(9 cases),grade C(14 cases),moderate varicose veins(6 cases),severe varicose veins(17 cases).There was no significant difference in age,gender,etiology,degree of esophageal and gastric varices and child Pugh score among the three groups(P > 0.05).In group 1,there were 64 cases with significant effect,21 cases were effective.Group 2 patients: 42 cases of significant effect,12 cases of effective,group 3 patients: 23 cases of significant effect,18 cases of effective.There was no significant difference(P > 0.05).In group 1,there were 19 with adverse reactions in total;in group 2,there were 11 with adverse reactions in total.In group 3,there were 8cases of adverse reactions.There was no significant difference among the three groups(P > 0.05).There was only one case of rebleeding in group 1,only one case of rebleeding in group 2 and no rebleeding in group 3.There was no significant difference among the three groups(P > 0.05).There was no significant difference among the three groups(P > 0.05).There were 4 times of hospitalization in group 1,3 times in group 2 and2 times in group 3.The difference was statistically significant(P < 0.05).After two comparisons,group 1 and group 2 were compared,P = 0,the difference was statistically significant(P < 0.05);group 1 and group 3were compared,P = 0,the difference was statistically significant(P <0.05);group 2 and group 3 were compared,P = 0.85,the difference was no statistically significant(P > 0.05).The total hospitalization time of group 1 was 32 days,that of group 2was 27 days,and that of group 3 was 20 days.There was statistically significant difference among the three groups(P < 0.05).After that,there was no significant difference between group 1 and group 2(P = 0.06,P >0.05);there was statistically significant difference between group 1 and group 3(P = 0.002,P < 0.05);there was no statistically significant difference between group 2 and group 3(P = 0.33,P > 0.05).Conclusion:1.EIS combined with endoscopic tissue adhesive treatment,EVL treatment,EVL combined with endoscopic tissue adhesive treatment were safe and effective,there was no significant difference in the efficacy(p> 0.05);2.2.There was no significant difference between the three groups in the incidence of rebleeding,adverse reactions and the total cost of hospitalization(p > 0.05);3.The number of hospitalization and days of hospitalization of EIS combined with endoscopic tissue adhesive therapy were less than that of EVL(p < 0.05),and the number of hospitalization of EVL combined with endoscopic tissue adhesive therapy was less than that of EVL(p<0.05),suggesting that EIS combined with endoscopic tissue adhesive therapy was beneficial to the rapid rehabilitation of patients with esophageal and gastric varices. |
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