内镜下套扎和注射硬化剂治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者疗效研究*

doi:10.3969/j.issn.1672-5069.2023.01.023

Abstract

Abstract: Objective The aim of this study was to investigate the efficacy of endoscopic varices ligation (EVL) and tissue glue injection (TGI) in the treatment of patients with hepatitis B liver cirrhosis (LC) and esophageal and gastric varices bleeding (EVB). Methods 80 patients with LC and EVB were encountered in our hospital between February 2016 and January 2021, and all were carefully managed by conventional hemostasis measures. 40 patients in the control taken propranolol orally after hemostasis, and another 40 patients in the observation group received EVL and TGI. All patients were followed-up for six months. The portal venous diameter (DPV), portal venous blood velocity (VPV) and blood quantities of portal vein (QPV) were detected by ultrasonography. Serum gastrin (GAS), motilin (MTL), lipid peroxide (LPO) and malondialdehyde (MDA) levels were assayed by ELISA. Results The amount of blood transfusion, hemostatic time and hospital stay in the observation group were (3.2±0.6) u,(23.8±5.1)h and (7.5±1.3)d, significantly less or shorter than [(5.0±0.9) u, (47.9±7.5)h and (12.1±1.5)d, respectively, P<0.05] in the control; after treatment, the VPV and QPV in the observation were (18.7±2.3)cm/s and (510.2±52.2) ml/min, both significantly lower than [(22.2±2.4)cm/s and (645.2±64.1)ml/min, respectively, P<0.05] in the control; serum GAS, MTL, LPO and MDA levels in the observation were (98.2±9.1)μg/ml, (219.5±20.2)ng/l, (5.1±1.5)U/l and (13.6±3.4)μmol/l, all significantly lower [(112.4±11.7)μg/ml,(251.2±20.4)ng/l,(15.2±6.8)U/l and (22.1±5.3)μmol/l, respectively, P<0.05]; at the end of six-month follow-up, the incidences of re-bleeding and fatality in the observation were 15.0% and 5.0%, both significantly lower than 40.0% and 30.0%(P<0.05) in the control group. Conclusion The EVL and TGI in the treatment of hepatitis B cirrhotics with complicated EVB is efficacious with a promising hemostatic effect and elevated survival, which warrants further clinical investigation.

Key words: Esophageal and gastric varices bleeding, Liver cirrhosis, Endoscopic varices ligation, Tissue glue injection, Therapy

Dai Huan, Li Kai, Zhu Yongxiang, et al. Efficacy of endoscopic ligation and tissue glue injection in the treatment of patients with hepatitis B liver cirrhosis and esophageal and gastric varices bleeding[J]. Journal of Practical Hepatology, 2023, 26(1): 87-90.

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Efficacy of endoscopic ligation and tissue glue injection in the treatment of patients with hepatitis B liver cirrhosis and esophageal and gastric varices bleeding

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