ABSTRACT
Objective To investigate the effect and safety of endoscopic injection of tissue adhesive in a modified method combined with ligation for esophageal and gastric varices. Methods 60 patients with esophageal and gastric varices were randomly distributed to the treatment group (group A),who was treated with the modi-fied sandwich method(lauromacrogol -tissue adhesive-lauromacrogol)and combined with ligation for esophageal varices. The treatment group were compared with that 60 controls(group B),who was treated with the traditional sandwich method (lipiodol - tissue adhesive - lipiodol) and combined with ligation for esophageal varices. The hemostatic rate ,rebleeding rate ,improvement rate of gastric varices ,the rates of esophageal varices disappear-ance and complications were compared. Results The hemostasis rate were 98.32% and 96.41% between the two groups (P > 0.05). The improvement rate of gastric va rices (94.83% vs. 82.50%,P < 0.05) and the rate of esophageal varices disappearance(86.67% vs. 76.67%,P < 0.05)in the group A were both higher than those in the group B(49.57% vs. 41.23% ,P < 0.05). The amount of tissue adhesive in the group A was lower than that in the group B(2.47 ± 0.79 mL vs. 3.02 ± 0.68 mL ,P<0.05). The incidence of rebleeding rate ,fever ,transient bacteremia were equal between the two groups(P > 0.05),but the rate of chest and abodminal pain in the group A was higher than those in the group B (70.00% vs. 53.33%,P < 0.05). 1 patient in the group B had ectopic pulmonary embolism ,but improved after treatment. Conclusions Endoscopic injection of tissue adhesive in a modified method combined with ligation is effective and safe for esophageal and gastric varices ,and is worthy fur-ther investigation.
ABSTRACT
Objective To investigate the effect and safety of endoscopic injection of tissue adhesive in a modified method combined with ligation for esophageal and gastric varices. Methods 60 patients with esophageal and gastric varices were randomly distributed to the treatment group (group A),who was treated with the modi-fied sandwich method(lauromacrogol -tissue adhesive-lauromacrogol)and combined with ligation for esophageal varices. The treatment group were compared with that 60 controls(group B),who was treated with the traditional sandwich method (lipiodol - tissue adhesive - lipiodol) and combined with ligation for esophageal varices. The hemostatic rate ,rebleeding rate ,improvement rate of gastric varices ,the rates of esophageal varices disappear-ance and complications were compared. Results The hemostasis rate were 98.32% and 96.41% between the two groups (P > 0.05). The improvement rate of gastric va rices (94.83% vs. 82.50%,P < 0.05) and the rate of esophageal varices disappearance(86.67% vs. 76.67%,P < 0.05)in the group A were both higher than those in the group B(49.57% vs. 41.23% ,P < 0.05). The amount of tissue adhesive in the group A was lower than that in the group B(2.47 ± 0.79 mL vs. 3.02 ± 0.68 mL ,P<0.05). The incidence of rebleeding rate ,fever ,transient bacteremia were equal between the two groups(P > 0.05),but the rate of chest and abodminal pain in the group A was higher than those in the group B (70.00% vs. 53.33%,P < 0.05). 1 patient in the group B had ectopic pulmonary embolism ,but improved after treatment. Conclusions Endoscopic injection of tissue adhesive in a modified method combined with ligation is effective and safe for esophageal and gastric varices ,and is worthy fur-ther investigation.
ABSTRACT
Objective To study the sedative and analgesic effects of different drugs on patients under-going endoscopic variceal ligation( EVL). Methods Sixty patients undergoing selective EVL were randomly assigned to three groups:pethidine group( A),propofol-fentanyl group( B)and dexmedetomidine-fentanyl group(C). Data concerning blood pressure,heart rate,peripheral oxygen saturation,Ramsay score,endo-scopic operation and anesthesia time,surgeons' satisfaction and adverse reactions were recorded. Follow-up was done 24 hours later to confirm the patients' satisfaction and incidence of intraoperative awareness. Results The Ramsay scores of group B(5. 2 ± 0. 3)and C(3. 5 ± 0. 4)were significantly higher than group A (1. 6 ± 0. 4)(P<0. 05). There was no cough,body movement and high blood pressure during the EVL in group B or C,while the incidences of these symptoms in group A(40%,40% and 30%)were obviously higher (P<0. 05). The surgeons'satisfaction of group B(9. 2 ± 0. 3)and C(9. 6 ± 0. 4)were significantly higher than that of group A(5. 0 ± 0. 4)(P<0. 05). The patients' satisfaction scores of group B(9. 6 ± 0. 3)and C (9. 6 ± 0. 4)were also markedly higher than that of group A(5. 4 ± 0. 3)(P<0. 05). There was no difference of operation time among the three groups. The anesthesia time of group A(44 ± 6)was obviously longer than those of group B(35 ± 4)and C(36 ± 5)(P<0. 05). There was no difference in patients'or surgeons'satis-faction,or anesthesia time between group B and C. But the incidences of bradycardia( 40%),hypotension(30%)and hyoxemia(30%)in group B were obviously higher than those of group C(5%,0,0)(P<0. 05). There was no intraoperative awareness in group B or C. Conclusion Both dexmedetomidine and propofol com-bined with fentanyl are superior to pethidine for patients undergoing EVL,while dexmedetomidine provides bet-ter hemodynamics and respiratory conditions compared with propofol.