Effects of different vascular diameter and pressure on complete ligation degree in vitro / 中华消化内镜杂志

ABSTRACT

Objective To explore the influence of different pressures and diameters in vitro on complete ligation degree of esophageal varices based on the principle of LDRf typing.Methods According to the different preset venous pressure,the experimental porcine veins were used to establish vascular pressure models and divided into three groups (group A 25-30 cmH2O,group B 35-40 cmH2O,group C 45-50 cmH2 O).The porcine esophagus was selected to establish models of esophageal varices,and divided into three groups according to the diameter of esophageal varices (group D1 0.4-1.0 cm,group D2 1.0-1.5 cm,group D3 1.6-2.0 cm).Influence of pressure and diameter on complete ligation degrees was evaluated by univariate and multivariate analysis.Results Group A completed 18 ligations (56.25％,18/32),group B 12 ligations (37.50％,12/32),and group C 11 ligations (33.33％,11/33),which were not significantly different by pressure (x2 =3.6126,P =0.0573).Group D1 completed 35 ligations (94.59％,35/37),group D2 6 ligations(16.67％,6/36),and D3 completed no ligation (0％,0/24),which were significantly different by diameter (x2 =38.0014,P =0.0000),indicating that the diameter of the varices exerted greater influence on the ligation degree.The logistic regression analysis showed that variceal pressure and diameter were the independent factors for complete ligation degree (P =0.000).Conclusion Complete ligation is effective and safe when the variceal diameter is 0.4-1.0 cm,or variceal pressure is 25-30 cm H2O.Endoscopic treatment for varices with the guide of LDRf typing is scientific and feasible.