Analytical and Quantitative Cytopathology and Histopathology
2021, Volume 43, Issue 6
Research Article
Experience in the Treatment of Gastroesophageal Variceal Bleeding Caused by Portal Hypertension in Cirrhosis by Restricted Rehydration Combined with Gastroscopy
 ,
 ,
 ,
 ,
 ,
 ,
 ,
 ,
1
Department of Gastroenterology, University of Jinan, Jinan, Shandong, China
2
Department of Gastroenterology, Bengbu Medical College, Bengbu, Anhui, China
3
Department of Neurology, Bengbu Medical College, Bengbu, Anhui, China
4
Department of Endoscopic Center, Bengbu Medical College, Bengbu, Anhui, China
Abstract
OBJECTIVE: To investigate the hemostatic effect and clinical prognosis of restricted rehydration combined with gastroscopy in the treatment of gastroesophageal varicose bleeding caused by portal hypertension (PHT) in cirrhosis. STUDY DESIGN: Forty liver cirrhotic patients with PHT and gastroesophageal variceal bleeding were divided into observation (n=21) and control (n=19) groups. The observation group was treated with early restricted rehydration and drugs, and 72 hours after the bleeding stopped, enhanced computed tomography portal venography was completed, and then the varicose veins were treated by gastroscopy under general anesthesia. The control group was treated with the same drugs and routine fluid replacement, then emergency gastroscope hemostasis was performed within 24-48 hours under waking state. RESULTS: After treatment 24 hours after admission, the observation group received rehydration, blood transfusion, and sodium chloride significantly less than the control group. The 2 groups were significantly different in terms of hematemesis or melena, lactic acid level, and model for end-stage liver disease (MELD) score. There was no difference in blood pressure between groups. The operation time of the observation group was significantly less than that of the control group. There were no intraoperative hemorrhage cases, no fever after treatment, no spontaneous peritonitis cases, no hepatic encephalopathy and ectopic embolism cases, and no rebleeding after operation. At 6 months' follow-up the variceal obliteration rate was 100%, with no rebleeding or death cases, while in the control group bleeding occurred in 14 patients during the operation, among which in 2 patients the bleeding failed to be stopped by gastroscopy. Postoperative rebleeding occurred in 3 patients, spontaneous peritonitis in 3 patients, hepatic encephalopathy in 2 patients, and cerebral infarction in 1 patient. After 6 months of follow-up 15 patients had varicose vein obliterated, and 3 cases had rebleeding. No patients died in either group. CONCLUSION: Restricted rehydration combined with gastroscopy in the treatment of PHT in cirrhosis with esophagogastric variceal bleeding can improve hemostatic effect, improve clinical prognosis, and reduce the risk of rebleeding. © Science Printers and Publishers, Inc.
Keywords
Recommended Articles
Research Article
Tongxinluo Protects the Pulmonary Microvascular Barrier in Chronic Obstructive Pulmonary Disease with Atherosclerosis via the Rac1/Cdc42 Pathway
...
Research Article
Hesperidin May Protect Gastric Tissue against Immobilization Stress
Research Article
Neurons in the medulla oblongata related to gastric mucosal lesion of rats subjected to restraint water-immersion stress
...
Research Article
Papillary serous cystadenocarcinoma with squamous differentiation: A case report
...
Loading Image...
Volume 43, Issue 6
Citations
228 Views
22 Downloads
Share this article
© Copyright ©AQCH is an Official Periodical of The International Academy of Cytology and the Italian Society of Urologic Pathology.