EVL治疗食管胃底静脉曲张破裂出血患者再出血风险预测模型的构建*

doi:10.3969/j.issn.1672-5069.2026.01.022

Abstract

Abstract: Objective The purpose of this study was to investigate risk factors impacting re-bleeding in patients with esophageal and gastric varices bleeding (EGVB) after endoscopic variceal ligation (EVL)treatment. Methods A total of 196 patients with EGVB were admitted to Changsha Central Hospital Affiliated to University of South China between January 2021 and January 2024, and 146 cases were assigned to training set and another 50 cases were assigned to validation set. All patients received EVL, some of them were treated with polidocanol injection in combination, and followed-up for 14 days. Multivariate Logistic regression analysis was applied to find risk factors, and receiver operating characteristic curve (ROC) was drawn to evaluate prediction efficacy. Results Re-bleeding was found in 55 patients (28.1%), of which, 40 cases (27.4%) in training set and 15 cases (30.0%, P>0.05) in validation set, out of our 196 patients with EGVB after treatment; in re-bleeding group, the diameter of esophageal varices (EV) was(1.0±0.2)cm, the number of ligation rings was (12.2±3.8) and the number of ligation times was (2.4±1.2), all significantly greater than [(0.7±0.1)cm, (10.4±3.1) and (2.4±1.2), respectively, P＜0.05] in non-re-bleeding group; multivariate Logistic regression analysis showed that diameter of EV, ligation rings and ligation times were all the independent risk factors for re-bleeding(P＜0.05); the ROC analysis demonstrated that the area under the curve (AUC) was 0.830(95%CI:0.767-0.881), with sensitivity (Se) of 84.2% and specificity (Sp) of 71.3% when the model we established was used to predict in the training set, and the AUC was 0.823(95%CI:0.761-0.875), with Se of 87.8% and Sp of 74.5% in validation set. Conclusion Clinicians should take risk factors for re-bleeding into consideration in clinical practice, and take an appropriate measures to deal with it for improving efficacy of hemostasis.

Key words: Esophageal and gastric fundus varices, Endoscopic variceal ligation, Re-bleeding, Risk factors, Prediction

Wang Xinping, Wu Hui, Feng Hui, et al. Risk factors impacting re-bleeding in patients with esophageal and gastric varices bleeding after endoscopic variceal ligation treatment[J]. Journal of Practical Hepatology, 2026, 29(1): 85-88.

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Risk factors impacting re-bleeding in patients with esophageal and gastric varices bleeding after endoscopic variceal ligation treatment

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