Efficacy of endoscopic sclerotherapy with lauromacrogol in treatment of severe esophageal variceal bleeding

Cui MeiLan; Jia YanSheng; Kang HaiYan; Yin ShuYing; Zheng HuanWei

doi:10.3969/j.issn.1001-5256.2017.12.013

Issue 12

Dec. 2017

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2017 > 33(12): 2321-2325

PDF( 1611 KB)

Efficacy of endoscopic sclerotherapy with lauromacrogol in treatment of severe esophageal variceal bleeding

DOI: 10.3969/j.issn.1001-5256.2017.12.013

Department of Liver Disease and Gastroenterology, The Fifth Hospital of Shijiazhuang

Research funding:

Received Date: 2017-05-02
Published Date: 2017-12-20

Abstract

Abstract

Objective To investigate the short-and long-term efficacy of endoscopic sclerotherapy with lauromacrogol in the treatment of cirrhotic patients with severe esophageal variceal bleeding. Methods A retrospective analysis was performed for the clinical data of 160 patients who underwent endoscopic sclerotherapy with lauromacrogol for the first time due to severe esophageal variceal bleeding caused by cirrhotic portal hypertension in The Fifth Hospital of Shijiazhuang from January 2011 to December 2014. These patients were divided into emergency treatment group with 66 patients and selective treatment group with 94 patients. All patients were followed up for 1-5 years, and a statistical analysis was performed for the success rate of hemostasis, short-term rebleeding rate, long-term rebleeding rate, and incidence of complications. The chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the t-test was used for comparison of continuous data between two groups. Results There were no significant differences between the emergency treatment group and the selective treatment group in the success rate of hemostasis ( 98. 48% vs 100. 00%, P > 0. 05) , rate of eradication or disappearance of varices ( 74. 24% vs 82. 98%, P > 0. 05) , time to the eradication or disappearance of varices ( 21. 4 ± 0. 3 d vs 20. 5 ±0. 3 d, P > 0. 05) , variceal recurrence rate ( 18. 18% vs 15. 96%, P > 0. 05) , time to variceal recurrence ( 17. 0 ± 1. 8 months vs 19. 2 ±2. 3 months, P > 0. 05) , long-term rebleeding rate ( 33. 33% vs 21. 28%, P > 0. 05) , and incidence rate of complications ( 22. 73% vs18. 09%, P > 0. 05) , while there was a significant difference in short-term rebleeding rate between the two groups ( 9. 09% vs 1. 06%, P = 0. 020) . Of all 160 patients, 8 ( 5. 00%) died during follow-up, including 5 patients in the emergency treatment group ( one each died of esophageal variceal bleeding, multiple organ failure, and rupture and bleeding of liver cancer nodules, and 2 died of hepatic encephalopathy) and 3 in the selective treatment group ( one patient each died of esophageal variceal bleeding, multiple organ failure, and rupture and bleeding of liver cancer nodules) . Conclusion Endoscopic sclerotherapy with lauromacrogol has marked short-and long-term efficacy in the treatment of severe esophageal variceal bleeding, and short-term rebleeding after emergency treatment should be taken seriously.
- esophageal and gastric varices,
- lauromacrogol injection,
- sclerotherapy,
- treatment outcome

FullText(HTML)

References(15)

References

[1]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Endoscopy, Chinese Medical Association.Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J].J Clin Hepatol, 2016, 32 (2) :203-219. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J].临床肝胆病杂志, 2016, 32 (2) :203-219.

[2] Committee of esophageal varicosity, Society of Digestive Endoscopy of Chinese Medical Association.Tentative guidelines for endoscopic diagnosis and treatment of varicosity and variceal bleeding in digestive tract (2009) [J].Chin J Dig Endosc, 2010, 27 (1) :1-4. (in Chinese) 中华医学会消化内镜学分会食管胃静脉曲张学组.消化道静脉曲张及出血的内镜诊断和治疗规范试行方案 (2009年) [J].中华消化内镜杂志, 2010, 27 (1) :1-4.

[3]LIU LS, SHENG JW.Application of kangfuxin in prevention of recent rebleeding after esophageal variceal ligation[J].Pract Clin Med, 2013, 14 (9) :21-22, 34. (in Chinese) 刘良生, 盛建文.康复新在预防食管静脉曲张套扎术后近期再出血中的作用[J].实用临床医学, 2013, 14 (9) :21-22, 34.

[4]CHEN P.Clinical effect of endoscopic esophageal variceal ligation in treatment of esophageal variceal bleeding:an analysis of 67 cases[J].Shandong Med J, 2011, 51 (7) :69-70. (in Chinese) 陈萍.内镜下食管静脉结扎术治疗管静脉曲张破裂出血67例分析[J].山东医药, 2011, 51 (7) :69-70.

[5]MEI ZC, HE L, CHEN WQ, et al.Evaluation of the effects of dense endoscopic ligation for bleeding esophageal varices[J].Chin J Hepatol, 2005, 13 (4) :294-296. (in Chinese) 梅浙川, 何璐, 陈伟庆, 等.密集多点结扎术治疗食管静脉曲张出血的临床疗效观察[J].中华肝脏病杂志, 2005, 13 (4) :294-296.

[6] Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Endoscopy, Chinese Medical Association.Consensus on prevention and treatment for gastroesophageal varices and variceal hemorrhage in liver cirrhosis (2008, Hangzhou) [J].Chin J Dig, 2008, 16 (8) :564-570. (in Chinese) 中华医学会消化病学分会, 中华医学会肝病学分会, 中华医学会内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治共识 (2008, 杭州) [J].中华消化杂志, 2008, 16 (8) :564-570.

[7]CHENG LF, WANG ZQ, CAI FC, et al.Retrospect of thirteen years’experience in sclerotherophy for esophageal variceal bleeding[J].Chin J Dig, 2001, 21 (11) :658-660. (in Chinese) 程留芳, 王志强, 蔡逢春, 等.食管静脉曲张出血硬化治疗十三年回顾[J].中华消化杂志, 2001, 21 (11) :658-660.

[8]YUE Y, TANG KY, SHAO LP, et al.Experience in the application of lauromacrogol in emergency treatment of esophageal variceal bleeding[J].J Huaihai Med, 2013, 31 (4) :351-352. (in Chinese) 岳玉, 汤克云, 邵利萍, 等.聚桂醇在急诊硬化治疗食管静脉曲张破裂出血中的应用体会[J].淮海医药, 2013, 31 (4) :351-352.

[9]LI BM, ZHU X, SHU X, et al.Endoscopic variceal ligation plus sclerotherapy for esophageal variceal bleeding[J].Chin J Dig Endosc, 2013, 30 (2) :67-70. (in Chinese) 李弼民, 朱萱, 舒徐, 等.肝硬化食管静脉曲张破裂出血序贯治疗的临床应用价值[J].中华消化内镜杂志, 2013, 30 (2) :67-70.

[10]DUAN Y, JIANG WW.Clinical effect of endoscopic lauromacrogol injection in treatment of esophageal varices:an analysis of 51 cases[J].China Prac Med, 2013, 8 (28) :191-192. (in Chinese) 段煜, 姜文文.51例内镜下注射聚桂醇硬化剂治疗食管静脉曲张疗效观察[J].中国实用医药, 2013, 8 (28) :191-192.

[11]ZHOU HH, XIANG XH, ZHANG MM.Diagnosis and treatment of primary bleeding from esophageal varices in cirrhotic patients from Yangzhou[J].J Clin Hepatol, 2015, 31 (3) :370-373. (in Chinese) 周宏华, 向晓星, 张描描.扬州地区肝硬化食管静脉曲张初次出血80例患者诊治分析[J].临床肝胆病杂志, 2015, 31 (3) :370-373.

[12]LIN XC, LIN W, CHENG LF, et al.Clinical effect of injection of high-dose sclerosing agent in treatment of esophageal and gastric varices[J].Shandong Med J, 2008, 48 (39) :101-102. (in Chinese) 林香春, 蔺武, 程留芳, 等.大剂量硬化剂注射治疗食管胃底静脉曲张疗效观察[J].山东医药, 2008, 48 (39) :101-102.

[13]WANG J, CHAI GJ, LIU YD.Formation of ulcer after esophageal variceal sc Ierotherapy and analysis of correlated factors[J].Chin JGastroenterol Hepatol, 2008, 17 (12) :1010-1012. (in Chinese) 王娟, 柴国君, 刘迎娣.食管静脉曲张硬化治疗后溃疡的发生及相关因素分析[J].胃肠病学和肝病学杂志, 2008, 17 (12) :1010-1012.

[14]MIAO LJ, SUN KW, WANG Y, et al.Retrospect of 12 years of emergent endoscopic varices sclerotherapy esophageal varices bleeding[J].Chin J Gastroenterol Hepatol, 2017, 26 (2) :181-183. (in Chinese) 苗鲁杰, 孙克文, 王扬, 等.急诊内镜下硬化治疗食管静脉曲张破裂大出血12年回顾[J].胃肠病学和肝病学杂志, 2017, 26 (2) :181-183.

[15]XU XY.Tendency of clinical treatment of gastroesophageal variceal bleeding in cirrhotic patients[J].J Pract Hepatol, 2013, 16 (3) :193-194. (in Chinese) 徐小元.肝硬化食管胃静脉曲张破裂出血的临床处理动向[J].实用肝脏病杂志, 2013, 16 (3) :193-194.

Relative Articles

[1]	Zhenglong ZHENG, Xianpeng XU, Baixue LI, Yue SU, Yilan XIE, Quansheng FENG. Influence of splenectomy on the course of liver cirrhosis and related mechanism[J]. Journal of Clinical Hepatology, 2023, 39(8): 1958-1965. doi: 10.3969/j.issn.1001-5256.2023.08.029
[2]	Mengying LIU, Weizhi LI, Peijie LI, Fuquan MA, Yuling CHEN, Huanhuan SUN, Tiantian GAO, Hui XUE. Comparison of endoscopic therapy and TIPS in prophylaxis and treatment of variceal bleeding in decompensated portal hypertension[J]. Journal of Clinical Hepatology, 2023, 39(7): 1529-1534. doi: 10.3969/j.issn.1001-5256.2023.07.003
[3]	Huimin LI, Yizhuo CHEN, Rui ZHAO, Xiao HUANG, Fei HUANG, Huanhuan LI. A comparative analysis of the hemogram and myelogram of patients with liver cirrhosis and the advantages and disadvantages of splenectomy[J]. Journal of Clinical Hepatology, 2023, 39(9): 2217-2224. doi: 10.3969/j.issn.1001-5256.2023.09.028
[4]	Huan WANG, Xiaoxu SHEN, Liangqi CHEN, Tianlan GONG. Association of JAK/STAT signaling pathway with portal vein thrombosis after splenectomy in cirrhotic patients with portal hypertension[J]. Journal of Clinical Hepatology, 2022, 38(10): 2260-2264. doi: 10.3969/j.issn.1001-5256.2022.10.012
[5]	Jiayin WANG, Hongyu ZHOU, Tinghong LI, Lei ZHAO, Baiguo XU, Weili YIN, Fang WANG, Jing LIANG, Xiang JING, Huiling XIANG. Value of ultrasonic shear-wave dispersion imaging in diagnosis of high-risk esophageal and gastric varices in compensated cirrhosis[J]. Journal of Clinical Hepatology, 2022, 38(7): 1554-1560. doi: 10.3969/j.issn.1001-5256.2022.07.018
[6]	Zhaopeng LI, Guangchuan WANG, Chunqing ZHANG. Value of transjugular intrahepatic portosystemic shunt in the prevention of esophageal variceal rebleeding in patients with portal vein thrombosis after splenectomy[J]. Journal of Clinical Hepatology, 2021, 37(6): 1331-1335. doi: 10.3969/j.issn.1001-5256.2021.06.023
[7]	Li XiaoLu, Ding HuiGuo, Ceng AJuan, Lu: XinYue, Li Lei. Clinical effect of terlipressin combined with somatostatin in treatment of esophagogastric variceal bleeding with liver cirrhosis[J]. Journal of Clinical Hepatology, 2020, 36(6): 1273-1277. doi: 10.3969/j.issn.1001-5256.2020.06.017
[8]	Xu Wei, Tu Bing. The role of devascularization in cirrhotic portal hypertension and related controversies[J]. Journal of Clinical Hepatology, 2020, 36(3): 670-672. doi: 10.3969/j.issn.1001-5256.2020.03.043
[9]	Mou SiYu, Yang Zhe, Wu LiQun, Qiu Xuan, Guo JiaMing. Predictive factors for portal vein thrombosis after splenectomy in cirrhotic patients with portal hypertension[J]. Journal of Clinical Hepatology, 2018, 34(1): 106-111. doi: 10.3969/j.issn.1001-5256.2018.01.022
[10]	Ao Fei, Chen WeiQing. Research advances in portal vein thrombosis after splenectomy in cirrhotic patients with portal hypertension[J]. Journal of Clinical Hepatology, 2018, 34(3): 631-634. doi: 10.3969/j.issn.1001-5256.2018.03.043
[11]	Kong DeGang, Lu ShiChun. Effect of splenectomy on liver cirrhosis and related surgical issues[J]. Journal of Clinical Hepatology, 2016, 32(12): 2383-2386. doi: 10.3969/j.issn.1001-5256.2016.12.033
[12]	Tang HanQiu. Clinical effect of laparoscopic splenectomy combined with esophagogastric devascularization in treatment of liver cirrhosis with portal hypertension[J]. Journal of Clinical Hepatology, 2016, 32(9): 1743-1746. doi: 10.3969/j.issn.1001-5256.2016.09.022
[13]	Zhang Lei, Yue Ping, Song XiaoJing, Yue Wei, Li Xun, Yuan Hong, Deng WanRong. Analysis of risk factors for rebleeding after splenectomy and pericardial devascularization in treatment of portal hypertension due to liver cirrhosis[J]. Journal of Clinical Hepatology, 2015, 31(3): 396-399. doi: 10.3969/j.issn.1001-5256.2015.03.020
[14]	Wu XiaoFeng, Fu Zhi, Liu ZhaoBo, Meng Jian, Li ChuanYun, Lin DongDong. Cause analysis of early portal vein thrombosis after esophagogastric devascularization and splenectomy in cirrhotic patients with portal hypertension[J]. Journal of Clinical Hepatology, 2015, 31(3): 400-403. doi: 10.3969/j.issn.1001-5256.2015.03.021
[15]	Wang ChaoYang, Ren JianZhuang, Han XinWei. Cavernous transformation of the portal vein after splenectomy: a report of one case[J]. Journal of Clinical Hepatology, 2015, 31(9): 1494-1495. doi: 10.3969/j.issn.1001-5256.2015.08.034
[16]	Zhou JinHang, Wu LiMing, Wang JiangHua, Wang Wei, Ji Lei. Postoperative complications of laparoscopic splenectomy in patients with portal hypertension[J]. Journal of Clinical Hepatology, 2015, 31(11): 1870-1873. doi: 10.3969/j.issn.1001-5256.2015.11.024
[17]	Bao HanKang, Wei XiuLi. Clinical effects of hand-assisted laparoscopic vs open splenectomy combined with pericardial devascularization the treatment of portal hypertension in liver cirrhosis[J]. Journal of Clinical Hepatology, 2015, 31(3): 431-433. doi: 10.3969/j.issn.1001-5256.2015.03.027
[18]	Yang ZhengMao, Zhang LingYi. Risk factors for portal vein thrombosis following splenectomy in patients with liver cirrhosis[J]. Journal of Clinical Hepatology, 2015, 31(7): 1173-1175. doi: 10.3969/j.issn.1001-5256.2015.07.044
[19]	Liu ChaoHui, Chen YiJie, Zhang ChengHua. Effects of splenectomy on peripheral blood Th17 cells and immune function in patients with portal hypertension[J]. Journal of Clinical Hepatology, 2014, 30(9): 887-890. doi: 10.3969/j.issn.1001-5256.2014.09.012
[20]	Yu ZhenNing, Yang Lin, Lu JianGuo. Effect of splenectomy plus pericardial devascularization on coagulation function in patients with cirrhotic portal hypertension[J]. Journal of Clinical Hepatology, 2014, 30(12): 1334-1336. doi: 10.3969/j.issn.1001-5256.2014.12.024

Supplements(0)

Cited By

Cited by

Periodical cited type(5)

1.	黄健佳，杨艳，万鑫，周光斌，陈晨，王飞兵，曹华斌. 血浆乳酸动态变化可作为母犬绝育术预后评估的重要参数. 中国兽医杂志. 2024(07): 136-143 .
2.	葛孝定，刘斐. 乙型肝炎病毒相关慢加急性肝衰竭的MELD评分变化及意义. 中国现代医生. 2023(13): 15-18 .
3.	殷春兰，赵瑞芹，付海燕，白革兰，程丽娟. 血脂及血乳酸在儿童CLD的表达水平及其临床意义. 川北医学院学报. 2023(06): 754-758+763 .
4.	谢冰鑫，王娜. 免疫球蛋白联合肝功能指标检测在肝衰竭诊断和预后判断中的价值. 中国医药指南. 2022(10): 107-109 .
5.	吴舒沁，吴倩，骆建军，蒋光伟，王黎鹏，邹春喜，杨箬箬，王晓霞，朱新新，孟威. 中心静脉血氧饱和度作为严重创伤低血容量休克患者容量复苏目标的生化指标的研究. 创伤外科杂志. 2021(12): 920-924 .

Other cited types(2)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (2234) PDF downloads(390)

Efficacy of endoscopic sclerotherapy with lauromacrogol in treatment of severe esophageal variceal bleeding

DOI: 10.3969/j.issn.1001-5256.2017.12.013