A randomized controlled study of CT portograph combined with endoscopic ultrasonography for the precision treatment of esophagogastric varices in patients with cirrhosis / 中华消化内镜杂志

ABSTRACT

Objective To investigate the efficacy and safety of CT portograph combined with endoscopic ultrasonography for the pricision treatment of esophagogastric varices in patients with cirrhosis. Methods A total of 130 inpatients with cirrhosis complicated with esophagogastric variceal bleeding who received endoscopic treatment from January 2013 to January 2015 were selected. Using prospective randomized controlled design, the patients were divided into two groups, the experimental group and the control group, with 65 cases in each group. The number and degree of esophagogastric varices were assessed by CT portography in the experimental group. Then endoscopic ultrasonography was used to assess the paraesophageal vein and perforator vein before endoscopic treatment. The range and degree of esophagogastric varices were observed and the lesions were treated by endoscopy in the control group. Results A total of 62 patients completed the study in the experimental group, and 63 in the control group. The number of treatment was significantly lower in the experimental group than that in the control group(3. 00±0. 76 VS 5. 63±0. 92, P=0. 000) . The disappearance time of varices was significantly shorter in the experimental group than that in the control group(7. 25±1. 16 months VS 8. 88±1. 64 months, P=0. 039). The variceal recurrence rate of the experimental group was significantly lower than that of the control group [ 1. 6％ ( 1/62 ) VS 12. 7％( 8/63) , P=0. 040] . The incidence of pleural effusion was significantly lower in the experimental group than that in the control group [ 0 ( 0/62 ) VS 9. 5％ ( 6/63 ) , P= 0. 040 ] . The total complication rate was significantly lower in the experimental group than that in the control group [ 27. 4％ ( 17/62 ) VS 58. 7％(37/63), P=0. 003]. Conclusion CT portography combined with endoscopic ultrasonography is safe and effective for esophageal gastric varices in patients with cirrhosis.