关键词: 肝硬化, 食管胃静脉曲张破裂出血, 硬化剂注射, 组织胶注射, 再出血, 危险因素

Abstract: Objective The aim of this study was to investigate the risk factors of re-bleeding in hepatitis B viral infection-induced liver cirrhosis (LC) complicated with esophagogastric varices bleeding (EGVB) within 1 year after gastroscopic sclerotherapy and tissue glue injection therapy. Methods A total of 137 patients with hepatitis B LC and EGVB were enrolled in our hospital between June 2016 and March 2021, and all patients underwent gastroscopic sclerotherapy and tissue glue injection therapy. They were all followed-up for 1 year to observe the occurrence of postoperative re-bleeding. The risk factors of re-bleeding were analyzed by multivariate Logistic regression analysis. Results Among the 137 patients with cirrhosis and EGVB, 28 patients (20.4%) died of emergent bleeding; out of the 109 survivals within 1 year of follow-up, the postoperative re-bleeding occurred in 42 cases (30.7%); there were significant differences between patients with re-bleeding and without re-bleeding as respect to Child-Pugh class (P=0.001), severity of esophageal varices (P=0.027), ascites volume (P=0.016) and malnutrition (P=0.009, P<0.05); the Logistic regression analysis showed that poor Child-Pugh class (OR=1.863), severe esophageal varices (OR=2.028), large volume of ascites (OR=1.797) and moderate to severe malnutrition (OR=1.589) were the independent risk factors for re-bleeding within 1 year after endoscopic therapy. Conclusion The patients with hepatitis B LC and EGVB after gastroscopic therapy could have high risk for re-bleeding within one year, and the careful intervention to these risk factors might decrease the incidence of re-bleeding and increase the survival rates of them.

Key words: Liver cirrhosis, Esophagogastric varices bleeding, Sclerotherapy, Tissue glue injection, Re-bleeding, Risk factors