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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 study the clinical efficacy and safety of endoscopic selective varies devascularization prospectively. Methods 180 cases of cirrhosis with esophagogastric variceal endoscopic treatment were included in the prospective analysis. They were treated with selective source of blood vessel devascularization using modified sandwich method (lauromacrogol-tissue adhesive-saline). The improvement rates, effective rates, significant effective rates, rebleeding rates and rates of complications were observed. Results One month after treatment, the significant effective rate of varices was 67.8% (122/180), effective rate was 30.0% (54/180), inefficient rate was 2.2% (4/180) and improvement rate was 97.8% (176/180). Within two weeks after treatment, the rebleeding rate was 3.3% (6/180). Within three months after treatment, the rebleeding rate was 7.2% (13/180). No serious complications occurred. The incidence of overall complication was 37.8% (68/180). Conclusion Endoscopic selective varies devascularization has good efficacy and safety, and is worth promoting.