ABSTRACT
To assess the effect of terlipressin on renal function in cirrhotic patients with esophageal gastric varices bleeding (EGVB) and normal baseline renal function. METHODS: Ninety six cirrhotic patients with EGVB enrolled in Fujian Provincial Hospital form January 2016 to January 2019 were reviewed retrospectively. The renal function and the factors associated with serum creatinine (Cr) reduction were explored. RESULTS: The lowest serum Cr (58.41±14.58) μmol/L vs. (66.20±16.27) μmol/L, P=0.015 and highest eGFR (105.16±19.36) mL·min-1·1.73 m-2) vs. (95.62±16.18) mL·min-1·1.73 m-2, P=0.011 were significantly different between patients treated with terlipressin and somatostatin. Serum Cr was significantly reduced (65.18±17.83) μmol/L vs. (58.41±14.58) μmol/L, P=0.001 and eGFR was significantly elevated (98.94±20.25) mL·min-1·1.73 m-2 vs. (105.16±19.36) mL·min-1·1.73 m-2, P<0.001 during the use of terlipressin. Logistic regression analysis revealed that higher baseline serum Cr was a risk factor for serum Cr reduction during the use of terlipressin (OR=1.076, 95%CI 1.015-1.142, P=0.015). The reduction of serum Cr was not significant after terlipressin was discontinued (65.18±17.83) μmol/L vs. (63.56±13.48) μmol/L, P=0.297. Somatostatin had no effect on serum Cr neither used or not (65.82±18.12) μmol/L vs. (66.20±16.27) μmol/L, P=0.766, (65.82±18.12) μmol/L vs. (68.24±17.99) μmol/L, P=0.085. CONCLUSION: Terlipressin can reduce serum creatinine and elevate eGFR of cirrhotic patients with EGVB and normal baseline renal function, and may be beneficial on preventing renal function impairment in cirrhotic patients with EGVB and normal baseline renal function.
ABSTRACT
Objective To compare the effect and survival period of endoscopic treatment group and non endoscopic treatment group of esophageal gastric varices bleeding in patients with hepatocellular carcinoma and portal vein tumor thrombus, in order to define the significance of endoscopic therapy for prolonging the survival period of patients. Methods 76 patients diagnosed as esophageal gastric varices bleeding with hepatocellular carcinoma and portal vein tumor thrombus from Jan. 2013 to Dec. 2015 were enrolled, of all these cases, 27 were non endoscopic treatment group and 49 were endoscopic treatment group. The medical records were analyzed retrospectively. Then compare the effect of emergency treatment, the main causes of death and survival time of the two groups. Results In the non endoscopic treatment group, 40.7% (11/27) patients died in one week after bleeding, 81.5% (22/27) patients died of esophageal gastric varices bleeding, the mean survival period was (42.03 ± 13.94) days; In the endoscopic treatment group, only 16.3% (8/49) patients died in one week (P < 0.05), 55.1% (27/49) patients died of esophageal gastric varices bleeding (P < 0.05), the mean survival time was (174.24 ± 34.42) days (P < 0.05). Conclusions Endoscopic therapy can effectively reduce the risk of death from acute hemorrhage and prolong the survival time in patients with hepatocellular carcinoma and portal vein tumor thrombus.
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Objective To explore the endoscopic Histoacryl injection in the treatment of gastric variceal hemorrhage based on the effect of psychological intervention. Methods 60 cases of patients with gastric variceal bleeding diagnosed in our hospital from January 2015 to March 2017 were randomly divided into control group and observation group according to the random number, 30 cases in each group.The control group was treated with endoscopic injection of tissue adhesive, the observation group were treated with endoscopic tissue adhesive and psychological care. The improvement of psychological status, treatment effect and prognosis were observed before and after treatment. Results The psychological state of patients in the observation group is better than control group, the treatment and the prognosis is better than the control group, there was statistical significant differences (P<0.05). Conclusion Endoscopic Histoacryl injection in the treatment of gastric variceal bleeding to the effect of psychological intervention can significantly. Fully improve the psychological state of patients, improve the clinical efficacy and prognosis, worthy of clinical application.
ABSTRACT
Objective To explore the endoscopic Histoacryl injection in the treatment of gastric variceal hemorrhage based on the effect of psychological intervention. Methods 60 cases of patients with gastric variceal bleeding diagnosed in our hospital from January 2015 to March 2017 were randomly divided into control group and observation group according to the random number, 30 cases in each group.The control group was treated with endoscopic injection of tissue adhesive, the observation group were treated with endoscopic tissue adhesive and psychological care. The improvement of psychological status, treatment effect and prognosis were observed before and after treatment. Results The psychological state of patients in the observation group is better than control group, the treatment and the prognosis is better than the control group, there was statistical significant differences (P<0.05). Conclusion Endoscopic Histoacryl injection in the treatment of gastric variceal bleeding to the effect of psychological intervention can significantly. Fully improve the psychological state of patients, improve the clinical efficacy and prognosis, worthy of clinical application.
ABSTRACT
N-butyl-2-cyanoacrylate (Histoacryl(R)) is used to obtain hemostasis in gastric variceal bleeding. Known complications of Histoacryl(R) injection therapy include bleeding, perforation, stenosis, and embolism. We report a case of adrenal abscess as a very rare complication of Histoacryl(R) injection. A 40-year-old male with liver cirrhosis was admitted with acute gastric variceal bleeding. Sclerotherapy using Histoacryl(R) mixed with lipiodol (3 mL) was successful. Twenty-seven months later, he was readmitted complaining of left flank pain and a fever of 39degreesC. Abdominal computed tomography (CT) showed a heterogeneous enhancing solid and cystic mass (6.1x3.0 cm) at the left adrenal gland. A left adrenalectomy was performed and the pathological examination confirmed a Histoacryl(R)-related adrenal abscess. We present this case along with a brief review of the literature