Clinical effect of endoscopic sclerosing agent and tissue glue injection combined with ligation for the treatment of rectal ectopic varices bleeding / 中国内镜杂志

ABSTRACT

Objective To explore the clinical effect of endoscopic sclerosing agent and tissue glue injection combined with ligation in the treatment of rectal ectopic varices(EV)bleeding.Method A retrospective analysis was conducted on 60 patients with rectal EV bleeding who received endoscopic treatment from January 2017 to January 2022.According to the surgical method,the patients were divided into two groups,with 30 cases in the control group receiving endoscopic ligation treatment;30 cases in the observation group were treated with endoscopic scleroing agent and tissue glue injection combined with ligation.Follow up was conducted according to a cycle of 1,3,6 and 12 months after surgery,and the following indicators were compared between the two groups of patientssuccessful surgical hemostasis rate,incidence of postoperative complications,mortality rate,improvement of postoperative varicose vein diameter,and postoperative response rate.Result The success rate of surgical hemostasis in the observation group was 93.3%,significantly higher than 66.7%in the control group,the incidence of abdominal pain and fever in the observation group was 10.0%and 10.0%,respectively,significantly lower than 33.3%and 36.7%in the control group,there were 2 deaths in the observation group and 9 deaths in the control group,the mortality rate in the observation group was 6.7%,significantly lower than the 30.0%in the control group,the preoperative venous diameter of the observation group was(1.60±0.36)cm,and the postoperative diameter continued to decrease,at the 12th month after surgery,the diameter was(0.78±0.31)cm,while in the control group,the preoperative venous diameter was(1.52±0.26)cm,the postoperative diameter continued to increase,and at the 12th month after surgery,the diameter was(1.55±0.36)cm,the postoperative effective rate of the observation group was significantly better than that of the control group,the differences were statistically significant(P<0.05).Conclusion The combination of endoscopic scleroing agent and tissue glue injection combined with ligation for the treatment of rectal EV bleeding has a higher success rate and effective rate of surgical hemostasis,fewer postoperative complications,lower mortality rate during follow-up observation,and satisfactory clinical efficacy.It is worth further promoting and applying in clinical practice.