Journal of Practical Hepatology ›› 2022, Vol. 25 ›› Issue (6): 865-868.doi: 10.3969/j.issn.1672-5069.2022.06.027

• Liver cirrhosis • Previous Articles     Next Articles

Short-term hemostatic effect of endoscopic variceal ligation and omeprazole and octreotide combination in the treatment of cirrhotics with first esophageal varices bleeding

Zhan Zhiyuan, Shen Yang, Wang Fanbing   

  1. Department of Gastroenterology, Second Affiliated Hospital, Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
  • Received:2021-11-24 Online:2022-11-10 Published:2022-11-22

Abstract: Objective The aim of this study was to investigate the short-term hemostatic effect of endoscopic variceal ligation (EVL) and omeprazole and octreotide combination in the treatment of cirrhotics with first esophageal varices bleeding (EVB). Methods 60 patients with cirrhosis and EVB were enrolled in this study between January 2018 and January 2021, and 30 patients in the control were treated with omeprazole and octreotide, while another 30 patients in the observation group were treated with EVL on the basis of medicines in the control group. The diameters, mean flow velocities and blood flows of portal vein and splenic vein were detected by color Doppler ultrasound. Serum gastrin (GAS) and glucagon (GLC) levels were detected by ELISA, and serum procollagen type III N-terminal peptide (PIIINP) level was detected by radioimmunoassay. Results 1 week after treatment, the total efficient rate in the observation group was significantly higher than that in the control group (96.7% vs. 76.8%, P<0.05), and the emergent hemostasis rate in the observation group was also higher than that in the control group (93.3% vs. 73.3%, P<0.05); the early re-bleeding rate and the delayed re-bleeding rate in the observation group were 10.0% and 3.3%, both significantly lower than 33.3% and 20.0% (P<0.05) in the control; the mean flow velocity and blood flow of portal vein in the observation group were (14.2±2.3) cm/s and (1224.6±173.2) mL/min, significantly higher than [(12.1±1.6) cm/s and (1030.7±164.5) mL/min, P<0.05], the mean flow velocity and blood flow of splenic vein in the observation group were (14.4±1.9)cm/s and (934.6±185.3)mL/min, both significantly higher than [(12.3±1.7)cm/s and (731.3±172.4)mL/min, respectively, P<0.05] in the control; serum PIIINP, GAS and GLC levels in the observation group were (173.6±19.5) μg/L, (69.7±9.6) ng/L and (52.3±7.1) ng/L, significantly lower than [(202.8±23.1) μg/L, (91.4±12.3) ng/L and (62.4±8.3) ng/L, respectively, P<0.05] in the control group; the total incidence of post-EVL complications, such as sore throat, retrosternal pain, dysphagia, abdominal distension, nausea and vomiting was 53.3%. Conclusion The short-term clinical hemostatic effect of EVL at base of omeprazole and octreotide combination is good in patients with liver cirrhosis and first EVB, which could improve hemodynamic states of portal system, with a relative safety.

Key words: Liver cirrhosis, Esophageal varices bleeding, Endoscopic variceal ligation, Omeprazole, Octreotide, Hemostasis