Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Forces of PLA, Qilihe District, 333Rd Binhenan Road, Lanzhou, 730050, Gansu, China.
The First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China.
Sci Rep. 2024 Mar 28;14(1):7364. doi: 10.1038/s41598-024-57791-8.
Esophagogastric variceal bleeding (EVB) is one of the common digestive system emergencies with poor prognosis and high rate of rebleeding after treatment. To explore the effects of endoscopic therapy and drug therapy on the prognosis and rebleeding of patients with EVB, and then select better treatment methods to effectively improve the prognosis. From January 2013 to December 2022, 965 patients with EVB who were hospitalized in gastroenterology Department of the 940 Hospital of Joint Logistic Support Forces of PLA were retrospectively analyzed. Patients were divided into endoscopic treatment group (ET, n = 586) and drug treatment group (DT, n = 379). Propensity score matching (PSM) analysis was performed in both groups, and the general information, efficacy and length of hospital stay were recorded. The patients were followed up for 3 months after bleeding control to determine whether rebleeding occurred. There were 286 cases in each group after PSM. Compared with DT group, ET had higher treatment success rate (P < 0.001), lower rebleeding rate (P < 0.001), lower mortality rate within 3 months, and no significant difference in total hospital stay (P > 0.05). Compared with drug therapy, endoscopic treatment of EVB has short-term efficacy advantages, and can effectively reduce the incidence of rebleeding and mortality within 3 months.
食管胃静脉曲张出血(EVB)是消化系统常见的急症之一,预后差,治疗后再出血率高。为探讨内镜治疗与药物治疗对 EVB 患者预后及再出血的影响,进而选择更好的治疗方法以有效改善预后。回顾性分析 2013 年 1 月至 2022 年 12 月解放军联勤保障部队第 940 医院消化内科收治的 965 例 EVB 患者的临床资料,根据治疗方法的不同分为内镜治疗组(ET 组,n=586)和药物治疗组(DT 组,n=379)。对两组患者进行倾向性评分匹配(PSM)分析,记录两组患者的一般资料、疗效及住院时间。出血控制后随访 3 个月,判断是否再出血。PSM 后两组各 286 例。与 DT 组比较,ET 组治疗有效率更高(P<0.001),再出血率更低(P<0.001),3 个月内病死率更低,总住院时间差异无统计学意义(P>0.05)。与药物治疗相比,内镜治疗 EVB 近期疗效优势明显,能有效降低 3 个月内再出血及病死率。