ABSTRACT
Astract: Objective To explore the efifcacy and safety of endoscopic tissue adhesive injection in treatment of gastric variceal bleeding from liver cirrhosis.Methods Object of study are 92 cirrhotic patients (72 male/20 female) in hospital, who had been diagnosed with gastric varices bleeding from June 2014 to May 2016. Child-Pugh score at presentation for cirrhotic patients was A-28; B-36; C-28. According to endoscopic classiifcation of gastric varices, GEV1 were detected in 80 patients, GEV2 in 12. All patients were treated with endoscopic hypertonic glucose tissue adhesive ‘sandwich’ injection.Result Successful injection rate was 100.0% in 92 patients, among which 40 patients had accepted emergency endoscopic treatment and the immediate hemostasis rate was 100.0%. 65 patients were Having gastroscope review after the injection six months, 22 patients were significantly effective, accounting for 33.8%; 38 patients were effective, accounting for 58.4%; 5 patients were invalid, accounting for 7.7%. All the patients were followed up in 1 to 24 months. The late-rebleeding rate was 2.2%. None of them were having early-rebleeding or dead; Complications the incidence of rebleeding rate which caused by removing the needles which trapped in the varices was 2.2%. The incidence of chest pain rate was 4.3%, the bloating rate was 6.5% and the ulceration rate was 15.2%. There was no complications like fever, infection, stomachache, embolism and so on.Conclusion With low rebleeding rate and light side-effect, endoscopic tissue adhesive injection in the treatment of gastric variceal bleeding caused by cirrhosis portal hypertension has really good effect.
ABSTRACT
Objective To explore the distributions and clinical characteristics of pathogenic bacteria in SAP patients with secondary infection.Methods We collected clinical data from SAP patients with secondary infection,to analyze the source of samples,pathogenic bacteria and its resistance to commonly used antimicrobial agents.Results (1) Samples Source:A total of 156 positive specimens were obtained,with the largest number from sputum samples (46.79％);The blood samples (70.59％) were collected most within 1 week,sputum samples (64.38％) from 1 week to 2 weeks,and pancreatic necrotic tissues or peripancreatic fluid samples (51.79％) after 3 weeks,with statistically significant differnces.(2) Pathogenic bacteria:156 strains were isolated including 86 strains (55.13％) of gram-negative bacteria (55.13％),of which acinetobacter baumannii and escherichia coli were the most commonly seen,followed by gram-positive bacteria of 41 strains (26.28％),and then fungus of 27 strains (18.59％).(3) Drug resistance:There was a high tolerance rate of commonly used antimicrobial agents,and the drug resistance rate of cinetobacter baumannii to carbapenems antibiotics was 88.00％.Conclusions SAP combined with secondary infection is mainly caused by gram-negative bacteria,and there is a high proportion of multidrug-resistant bacteria.Selecting suitable antimicrobial agents according to bacterial culture is beneficial for the early control of infections.