Risk factors analysis of early rebleeding after endoscopic treatment of esophageal varices / 中华消化内镜杂志

ABSTRACT

Objective To investigate the risk factors of early rebleeding after endoscopic treatment of esophageal varices. Methods A retrospective analysis was performed on the clinical data of 384 cirrhotic patients with esophageal varices. The factors of early rebleeding group[n=36(9.4%)]and non?bleeding group(n=348)were compared by single factor analysis and multivariate analysis of Logistic regression. Results Single factor analysis showed that there were differences between the two groups in cirrhosis with hepatocellular carcinoma, Child?Pugh classification, Child?Pugh score, ascites volume, portal vein thrombosis, portal vein width, portal hypertensive gastropathy, shapes and numbers of varicose veins, numbers of varicose vein ligation, varicose vein red syndrome, albumin, total bilirubin, prothrombin time, prothrombin activity and platelet number. Further multivariate analysis showed that mass ascites(P=0.000, OR=7.614,95%CI 3.590?16.147), portal vein thrombosis(P=0.003, OR=2.867, 95%CI 1.429?5.750),portal hypertensive gastropathy(P=0.000, OR=6.212, 95%CI 3.036?12.711), and Child?Pugh C(P=0.008,OR=3.078,95%CI1.338?7.083)were independent risk factors of early rebleeding after endoscopic treatment. Conclusion The early rebleeding rate was high after endoscopic treatment of esophageal varices. Patients with massive ascites,portal vein thrombosis,portal hypertensive gastropathy and Child?Pugh C should be highly vigilant for early rebleeding.