RESUMO
Objective To evaluate the clinical efficacy and safety of endoscopic selective varices devascularization.Methods From November 2015 to July 2017,at the First Affiliated Hospital of Anhui Medical University,282 patients with liver cirrhosis complicated with gastroesophageal varices who underwent endoscopic treatment were selected and divided into traditional treatment group (n=102) and selective treatment group (n=180).The patients of traditional treatment group were treated with tissue glue "sandwich method" (lipiodol-tissue glue-lipiodol),and the patients of selective treatment group were treated with modified " sandwich method" (lauromacrogol-tissue glue-0.9％ sodium chloride solution).After operation,all the patients were followed up for three months.The rates of remarkable efficacy,efficacy,improvement,rebleeding and complications were compared between the two groups respectively.T test,chi-square test and rank sum test were performed for groups comparison.Results One month after operation,the rates of remarkable efficacy and efficacy of the traditional treatment group and the selective treatment group were 46.1％ (47/102) and 20.6％ (21/102),and 67.8％ (122/180) and 30.0％ (54/180),respectively.The results of rank sum test indicated that the differences in rates of remarkable efficacy and efficacy between two groups were statistically significant (Z=-5.428,bilateral P＜0.05).The improvement rate of the selective treatment group was higher than that of the traditional treatment group (97.8％,176/180 vs.66.7％,68/102),and the difference was statistically significant (x2-54.048,P＜ 0.05).At two weeks and three months after operation,the rebleeding rate of traditional treatment group was higher than that of selective treatment group (10.8 ％,11/102 vs.3.3 ％,6/180;21.6％,22/102 vs.7.2％,13/180),and the difference was statistically significant (x2 =6.380 and 12.327,both P＜0.05).No serious complications occurred in both groups.There was no statistically significant difference in overall complication rate between selective treatment group and traditional treatment group (37.8％,68/180 vs.30.4％,31/102;x2 =1.559,P-0.212).Conclusion The treatment with endoscopic selective varices devascularization shows good efficacy and safety,and is worth further study.
RESUMO
Objective To evaluate the clinical efficacy and safety of endoscopic selective varices devascularization. Methods A retrospective analysis was performed on the data of 153 cirrhosis patients with esophagogastric varices undergoing endoscopic treatment. The traditional treatment group with 70 cases underwent traditional "sandwich method"(lipiodol?tissue adhesive?lipiodol), and the selective treatment group with 83 cases was treated by modified"sandwich method"(lauromacrogol?tissue adhesive?saline)with selective varices devascularization.The improvement rate,effective rate,significant effective rate,rebleeding rate and complications were compared between the two groups.Results One month after treatment,28 cases (47.8%)were significant effective and 15 cases(19.6%)were effective in the traditional treatment group;and 48 cases(60.0%)were significant effective and 24 cases(20.0%)were effective in the selective treatment group. The difference on effective rate and significant effective rate was statistically significant (rs=-0.260,P=0.001). Improvement rate of the traditional treatment group and selective treatment group was 61.4%(43/70)and 86.7%(72/83)respectively,and the difference was statistically significant(χ2=11.626,P=0.001).Within two weeks after treatment, the rebleeding rate of the two group was 8.57%(6/70)and 4.82%(4/83), respectively, and there was no significant difference(bilateral P=0.514, unilateral P=0.271). Within three months after treatment, the rebleeding rate of the traditional treatment group was significantly higher than that of the selective treatment group[21.4%(15/70)VS 9.3%(8/83),χ2=4.133,P=0.042]. No serious complications occurred in the two groups. The incidence of overall complication of the selective treatment group was slightly higher than that of the traditional treatment group [33.7%(28/83)VS 27.1%(19/70)], but the difference was not statistically significant(P>0.05). Conclusion Endoscopic selective varices devascularization has good efficacy and safety, and is worthy of further study.