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• W4280567995 abstract "Objective: To investigate the effects of primary preventive treatment under endoscope for esophageal and gastric varices on bleeding rate and its relevant factors. Methods: 127 cases with liver cirrhosis accompanied with esophageal and gastric varices without bleeding history were included in the endoscopic and non-endoscopic treatment group, respectively. Informed consent was obtained from both groups. Gastric varices (Lgf) and esophageal varices (Leg) were diagnosed according to LDRf classification criteria, and the corresponding treatment scheme was selected according to the recommended principle of this method.The incidence rate of bleeding from ruptured esophageal varices were observed at 3, 6 months, and 1, and 2 years in the treated and the untreated group, and the patients with different Child-Pugh scores were followed-up for 2 years. Gender, age, etiology, varicose degree, Child-Pugh grade, platelet count, prothrombin activity, portal vein thrombosis, collateral circulation, portal vein width and other factors affecting the bleeding rate were assessed. Measurement data were described as mean ± standard deviation (x¯±s), and qualitative data of categorical variables were expressed as percentage (%), and χ2 test was used. Results: 127 cases were followed up for 2 years. There were 55 cases in the endoscopic treatment group (18 cases underwent band ligation, 2 cases underwent band ligation combined with tissue adhesive embolization, 28 cases underwent sclerotherapy, and 7 cases underwent sclerotherapy combined with tissue adhesive embolization). Recurrent bleeding and hemorrhage was occurred in 5 (9.1%) and 28 cases (38.9%), respectively (P<0.05). In addition, there were 72 cases in the untreated group (P<0.05). Severe varicose veins proportions in treated and untreated group were 91.1% and 85.1%, respectively (P>0.05). There was no statistically significant difference in liver cirrhosis-related medication and β-blocker therapy between the treated and untreated group (P>0.05). There was no statistically significant difference in the bleeding rate between the different treated groups (P>0.05). The bleeding rates at 3, 6 months, 1, and 2 years in endoscopic treated and untreated group were 2.00% vs. 2.59% (P>0.05), 2.30% vs. 5.88% (P>0.05), 3.10% vs. 7.55% (P>0.05) and 4.00% vs. 21.62% (P<0.05), respectively. All patients with Child-Pugh grade A, B and C in the treated and the untreated group were followed-up for 2 years, and the bleeding rates were 1.8% vs. 8.1% (P<0.05), 1.1% vs. 9.4% (P<0.05) and 9.1% vs. 10.1% (P>0.05), respectively. There were statistically significant differences in the rupture and bleeding of esophageal and gastric varices, varices degree, Child-Pugh grade and presence or absence of thrombosis formation in portal vein (P<0.05); however, no statistically significant differences in gender, age, etiology, platelet count, prothrombin activity, collateral circulation and portal vein width (P>0.05). There was no intraoperative bleeding and postoperative related serious complications in the treated group. Conclusion: The risk of initial episodes of bleeding from esophageal and gastric varices is significantly correlated with the varices degree, Child-Pugh grade, and portal vein thrombosis. Primary preventive treatment under endoscope is safe and effective for reducing the long-term variceal bleeding risk from esophageal and gastric varices.目的： 探讨内镜下一级预防治疗对食管胃静脉曲张出血率的影响及其相关因素。 方法： 127例肝硬化伴食管静脉曲张无出血史患者在知情同意情况下分别纳入内镜治疗组及无内镜治疗组，依据LDRf分型明确诊断胃静脉曲张（Lgf）及食管静脉曲张（Le，g），并遵循该方法建议原则选择相应治疗方案，观察治疗组及未治疗组3个月、6个月、1年及2年食管静脉曲张破裂出血的发生率及不同Child-Pugh评分患者随访2年的出血率，以及评估性别、年龄、病因、曲张程度、Child-Pugh分级、血小板计数、凝血酶原活动度、门静脉栓子、侧支循环、门静脉宽度等因素对出血的影响。计量资料以均数±标准差（x¯±s）描述，分类变量定性资料采用百分率（%）表示，用χ2检验。 结果： 127例患者随访2年，内镜治疗组55例（套扎术18例，套扎术联合组织黏合剂栓塞术2例，硬化术28例，硬化术联合组织黏合剂栓塞术7例），复发出血5例（9.1%），未治疗组72例，出血28例（38.9%）（P<0.05）；治疗组及未治疗组重度静脉曲张所占比率分别为91.1%及85.1%（P>0.05）；治疗组及未治疗组间肝硬化相关用药及β受体阻滞剂治疗差异无统计学意义（P>0.05）；不同治疗方法组间出血率差异无统计学意义（P>0.05）；3个月、6个月、1年及2年内镜治疗组和未治疗组出血率分别是2.00%比2.59%（P>0.05）、2.30%比5.88%（P>0.05）、3.10%比7.55%（P>0.05）及4.00%比21.62%（P<0.05）；治疗组和未治疗组的Child-Pugh A级、B级和C级患者均随访2年，其出血率分别为1.8%比8.1%（P<0.05）、1.1%比9.4%（P<0.05）及9.1%比10.1%（P>0.05）；食管胃静脉曲张破裂出血与曲张程度、Child-Pugh分级及门静脉是否有栓子差异有统计学意义（P<0.05），与性别、年龄、病因、血小板计数、凝血酶原活动度、侧支循环、门静脉宽度差异无统计学意义（P>0.05）。治疗组患者均未发生术中出血及术后相关严重并发症。 结论： 食管胃静脉曲张首次出血风险与曲张程度、Child-Pugh分级及门静脉栓子有明显相关性；食管胃静脉曲张内镜下一级预防治疗安全有效，可有效降低静脉曲张远期出血风险。." @default.
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• W4280567995 date "2022-04-20" @default.
• W4280567995 modified "2023-09-27" @default.
• W4280567995 title "[Effects of primary preventive treatment under endoscope for esophageal and gastric varices on bleeding rate and its relevant factors]." @default.
• W4280567995 doi "https://doi.org/10.3760/cma.j.cn501113-20200529-00284" @default.
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