关键词: 肝硬化, 食管静脉曲张, 球囊压迫内镜下硬化剂注射术, 内镜下曲张静脉套扎术, 治疗

Abstract: Objective The purpose of this study was to investigate the effect of balloon-compression endoscopic injection sclerotherapy (bc-EIS) in the treatment of patients with decompensated stage of hepatitis B cirrhosis and esophageal varices (EV), and the impact on rebleeding rate. Methods 78 patients with decompensated stage of hepatitis B cirrhosis and EV were diagnosed and treated in our hospital between January 2021 and January 2022. All of them were given conventional treatments such as acid suppression, hemostasis and blood transfusion. Among them, 39 patients received endoscopic variceal ligation (EVL) (control group) and 39 patients received bc-EIS (observation group). All patients were followed up for twelve months. Curative effect, treatment indicators, adverse reactions and prognosis were compared between the groups. Ultrasound was used to measure portal vein diameter (PVD), portal vein velocity (PVV), splenic vein diameter (SVD) and splenic vein velocity (SVV). Results The first variceal eradication rate and esophageal varices eradication rate after 1 to 2 times in the observation group were 87.2% and 100.00%, significantly higher than that in the control group (66.7% and 89.7%, P<0.05). The number of treatments, hospitalization time, and treatment costs for achieving EV eradication in the observation group were (1.6±0.3) times, (7.7±1.0) days and (19±6) thousand yuan, lower than those in the control group[(2.4±0.5) times, (10.1±1.3) days, and (26±7) thousand yuan, P<0.05]. During the 6 months of follow-up, PVV and SVV in the observation group were (19.04±2.12) cm/s and (21.35±2.25) cm/s, significantly higher than those in the control group[(22.49±2.37) cm/s and (19.58±2.61) cm/s, P<0.05)]. The incidence of esophageal ulcers in the observation group was 35.9%, significantly higher than the control group (17.9%, P<0.05). During the 6 months of follow-up, the recurrence rate and rebleeding rate of EV in the observation group were 2.7% and 2.7%, significantly lower than that in the control group (20.0% and 22.9%, P<0.05). During the 12 months of follow-up,the recurrence rate and rebleeding rate of EV in the observation group were 3.0% and 6.1%, significantly lower than that in the control group (26.7% and 33.3%, P<0.05). Conclusion bc-EIS can improve curative effect on hepatitis B cirrhosis with EV, reduce the incidence of EV recurrence and rebleeding by improving portal and splenic venous hemodynamics, and alleviate the economic burden on patients.

Key words: Decompensated stage of hepatitis B cirrhosis, Esophageal varices, Balloon compression, Endoscopic injection sclerotherapy, Rebleeding rate, Treatment